Conjoint Associate Professor Vicki Clifton

Conjoint Associate Professor

School of Medicine and Public Health

Career Summary

Biography

I have a strong background in fetal growth, reproductive endocrinology and placental physiology. My research has examined aspects of placental and myometrial function. I also have strengths in fetal physiology from my postdoctoral work at the University of Toronto, Canada working with leading fetal physiologist, Prof John Challis and with the study of the effect of asthma during pregnancy on placental function and fetal development. My research interests have evolved into an investigation of those factors that program fetal development, in particular activation of the immune system. I presently conduct my research both independently and as a team member. As an initiative, I identified asthma as a common condition in pregnancy involving inflammation that might provide a valuable model in which to study the effects of an inflammatory process on the outcome of the pregnancy. Our results have been startling, identifying an important sex dependent difference in the fetal growth response to maternal asthma. The results have lead to many prizes for my students, publications in the asthma and obstetric literature and reviews in high impact factor journals such as Endocrine Reviews. Clinically this study has demonstrated that asthmatic women require extra care during their pregnancies and resulted in funding by NHMRC (2007-2010) for a randomized control trial for treatment regimes specifically for pregnant asthmatic women. Scientifically this work has started to create a picture of what sex specific factors are involved in preterm delivery and fetal development in pathological pregnancies. This work has been generously funded by The Asthma Foundation of NSW for the last 10 years and by an NHMRC priming grant and project grant for the last 6 years. I was the sole investigator on these grants. I was awarded The Arthur Wilson Memorial Fellowship for 2002-2003 from the Royal Australian and New Zealand Society of Obstetricians and Gynaecologists, and an NHMRC Career Development Award (2004-2009) for this work. I received the Gabor Than Award in Placentology from the International Federation of Placental Associations in 2003 for my asthma and pregnancy research and presented in a plenary session at the annual meeting in Mainz 2003. The most exciting aspect of doing the research in asthma and pregnancy is to find that our work has had a clinical impact and has contributed to the formulation of the NIH American Guidelines for the treatment of asthma during pregnancy (J Allergy Clin Immunol 2005; 115:34-46). My asthma and pregnancy research has a wide audience as the work has been presented at both international thoracic societies and international societies associated with reproduction and fetal growth. I have published consistently every year over the last five years in medium to high impact journals related to my field. These are specialized contributions in internationally recognized journals in both obstetric and respiratory fields. I am consistently invited each year to present my work in plenary sessions and I regularly Chair conference sessions. I am the Treasurer of the Endocrine Society of Australia (2004-present). I am Executive member of the International Federations of Placental Associations since 2001. My leadership skills in research and research training have been recognized with my promotion to Associate Professor and Deputy Director of Mothers and Babies Research Centre.

Research Expertise
My work is based in a clinical setting with a focus on Human maternal-fetal-neonatal medical research. All of my primary studies involve prospectively following pregnant women and their children and examining mechanism that influence fetal growth and survival.

Teaching Expertise
I am predominantly focussed on postgraduate teaching with Honours, masters and PhD students.

Administrative Expertise
I have worked as a research development manager for the Faculty of Health and I am the deputy director of the Mothers and Babies research centre and in the Reproductive Sciences PRC. My admin involves leadership and management roles within these centres. 

Qualifications

  • PhD, University of Newcastle
  • Bachelor of Science (Honours), University of Newcastle

Keywords

  • Fetal physiology
  • Neonatal cardiovascular adapatation
  • Placental physiology
  • Reproductive physiology
  • asthma
  • endocrinology
  • neonatal development
  • pregnancy

Fields of Research

Code Description Percentage
110399 Clinical Sciences not elsewhere classified 25
111499 Paediatrics and Reproductive Medicine not elsewhere classified 50
110299 Cardiorespiratory Medicine and Haematology not elsewhere classified 25

Professional Experience

Academic appointment

Dates Title Organisation / Department
1/09/2004 - 1/12/2007 Treasurer Endocrine Society of Australia
Australia
1/01/2004 - 1/12/2008 Fellow NHMRC (National Health & Medical Research Council)
1/01/2004 - 1/12/2004 Research Development Manager University of Newcastle
Australia
1/01/2004 - 1/12/2007 NHMRC Career Development Award University of Newcastle
Australia
1/01/2000 - 1/12/2002 Senior Lecturer University of Newcastle
Australia
1/01/1998 - 1/12/1999 Brawn Postdoctoral Fellow University of Newcastle
Australia
1/07/1995 - 1/12/1996 Postdoctoral Fellow

Fetal Physiology

University of Toronto
Department Obstetrics, Gynaecology and Physiology, Faculty of Medicine
Canada

Membership

Dates Title Organisation / Department
Executive Committee Member/ Treasurer Endocrine Society of Australia
Australia
Member - Australian Society of Medical Research Australian Society of Medical Research
Australia
Member - Perinatal Society of Australia and New Zealand Perinatal Society of Australia and New Zealand
Australia
Member - Developmental Origins of Adult Disease Developmental Origins of Adult Disease
Australia
Member - Society of Gynecologic Investigation Society of Gynecologic Investigation
Australia
NHMRC GRP Panel Member NHMRC GRP
Obstetric/ gynaecology/ paediatric/ neonatal GRP
Australia
Executive Committee Member International Federation of Placental Associations
Australia

Awards

Research Award

Year Award
2003 Gabor Than Award in Placentology
International Federation of Placental Associations

Invitations

Participant

Year Title / Rationale
2003 Plenary speaker
Organisation: International federation of placental associations
Edit

Publications

For publications that are currently unpublished or in-press, details are shown in italics.


Chapter (9 outputs)

Year Citation Altmetrics Link
2015 Petraglia F, Orlandini C, Vannuccini S, Clifton VL, 'PCOS and pregnancy: Impact of endocrine and metabolic factors', Metabolic Syndrome and Complications of Pregnancy: The Potential Preventive Role of Nutrition 91-102 (2015)

© Springer International Publishing Switzerland 2015. Polycystic ovary syndrome (PCOS) is one of the most common endocrinemetabolic disorders, characterized by hyperandrogenism, ... [more]

© Springer International Publishing Switzerland 2015. Polycystic ovary syndrome (PCOS) is one of the most common endocrinemetabolic disorders, characterized by hyperandrogenism, hyperinsulinism, and polycystic ovaries.The origin of PCOS includes genetic factors and lifestyle influences.Elevated estrogen and androgens, low levels of progesterone, anovulation, and hyperinsulinemia contribute to endometrial, hormonal, and metabolic dysfunctions leading to adverse pregnancy outcome.In fact, women with PCOS have an increased risk of gestational diabetes, pregnancy-induced hypertension, preeclampsia, preterm birth, and need of cesarean section.Moreover, the comorbidity of obesity may increase the risk of obstetric complications since excess adipose tissue acts as an endocrine and inflammatory organ, with altered concentrations in leptin, TNF-±, and IL-6.Lifestyle modification may improve biochemical and endocrinological parameters, preventing progression of PCOS to type 2 diabetes and cardiovascular diseases later in life.Nutritional interventions, with or without metabolic drugs, are used as therapeutic tool.

DOI 10.1007/978-3-319-16853-1_7
2013 Carson KV, Robertson TA, Brinn MP, Clifton VL, Esterman AJ, Peters M, Smith BJ, 'Tobacco use, cessation and prevention for indigenous populations: Review of current evidence and future perspectives', Health Disparities: Epidemiology, Racial/Ethnic and Socioeconomic Risk Factors and Strategies for Elimination 1-37 (2013)

Significant advances in tobacco cessation and prevention initiatives have occurred over recent years, yet smoking amongst Indigenous populations remain double that of the relevant... [more]

Significant advances in tobacco cessation and prevention initiatives have occurred over recent years, yet smoking amongst Indigenous populations remain double that of the relevant non-Indigenous population. As such tobacco use is considered a significant risk factor contributing to health disparities among these populations. Two Cochrane systematic reviews, one evaluating tobacco cessation and the other tobacco prevention initiatives for Indigenous populations summarize the available evidence for use by policy makers, researchers and consumers alike. Culturally tailored tobacco cessation initiatives show evidence of long-term abstinence, however, both cessation and preventioninitiatives specifically designed in collaboration with Indigenous cohorts are lacking. Despite the significant health burden attributed to tobacco use including the development of tobacco related illnesses and associated economic expenditures, there remains a paucity of data in this field. Methodologically rigorous collaborative research is needed to highlight the barriers and facilitators for tobacco cessation and prevention programs inorder to effectively reduce the prevalence of tobacco use and subsequent co-morbidities. NOTE: This chapter (text, tables and figures) contain excerpts from articles published previously. Please refer to Carson and colleagues (2012a, 2012b and 2012c) in the reference list at the end of this chapter. © 2013 by Nova Science Publishers, Inc. All rights reserved.

Citations Scopus - 3
2012 Wright IMR, Stark MJ, Clifton VL, 'Assessment of the microcirculation in the neonate', Hemodynamics and Cardiology 215-234 (2012)
DOI 10.1016/B978-1-4377-2763-0.00011-1
Citations Scopus - 1
Co-authors Ian Wright
2012 Clifton VL, Smith B, Roy A, Osei-Kumah A, Hodyl N, Stark MJ, et al., 'Asthma during pregnancy', Advances in Asthma Management 105-113 (2012)

Asthma is a serious complication that is often under-reported and undermanaged during pregnancy. The current guidelines for the care of pregnant asthmatics are similar to treating... [more]

Asthma is a serious complication that is often under-reported and undermanaged during pregnancy. The current guidelines for the care of pregnant asthmatics are similar to treating a nonpregnant asthmatic It is important to treat asthma exacerbations during pregnancy to avoid a poor outcome for the fetus. The best clinical approach for reducing exacerbation rates during pregnancy and improving the outcome for the fetus is through asthma education combined with an asthma self-management plan administered in a combined antenatal and respiratory clinic.

DOI 10.2217/EBO.11.61
2006 Murphy VE, Smith R, Giles WB, Clifton VL, 'The role of the mother, placenta, and fetus in the control of fetal growth during human pregnancy', Perinatal Programming: Early Life Determinants of Adult Health & Disease, Taylor & Francis, London 3-16 (2006) [B1]
Co-authors Roger Smith, Vanessa Murphy
2005 Smith R, Mesiano S, Nicholson RC, Clifton VL, Zakar T, Chan EC, et al., 'The Regulation of Human Parturition', Birth, Distress and Disease: Placental-Brain Interactions, Cambridge University Press, Cambridge 77-90 (2005) [B1]
Co-authors Roger Smith
2005 Smith R, Mesiano S, Nicholson R, Clifton V, Zakar T, Chan EC, et al., 'The regulation of human parturition', Birth, Distress and Disease: Placental-Brain Interactions 74-87 (2005)

Preterm birth accounts for 70% of neonatal mortality and is a common cause for intellectual handicap among survivors. Approximately 50% of cases of cerebral palsy are associated w... [more]

Preterm birth accounts for 70% of neonatal mortality and is a common cause for intellectual handicap among survivors. Approximately 50% of cases of cerebral palsy are associated with preterm birth, in turn preterm birth increases the risk of cerebral palsy by 40 times! (Goldenberg, 2002). Preterm labor thus afflicts individuals at the very beginning of their lives, depriving them of opportunities and increasing health and educational costs for families and society in general. Unfortunately the rates of preterm birth have not changed for over 30 years due to an inability to predict the event and lack of effective therapies. This clinical problem has driven research into the mechanisms that regulate the timing of human birth and the disorders which cause preterm birth. For reasons of ethics most research in the past has focused on animal work, especially in the sheep. Unfortunately studies have revealed substantial differences between parturition in humans and that in other animals. Thus animal studies provide us with clues as to how systems operate to regulate delivery in mammals but frustrate us with uncertainty as to whether particular mechanisms operate in the human. Experimental in vivo studies provide the strongest evidence for cause and effect, yet the closer we come to the human state in our near relatives the apes, the larger the ethical constraints on experimental studies become.

DOI 10.1017/CBO9780511545658.004
Citations Scopus - 8
Co-authors Roger Smith
2004 Smith R, Mesiano S, Nicholson RC, Zakar T, Chan EC, Bisits AM, et al., 'Control of the length of gestation: lessons from women', Preterm Birth, RCOG Press, London 13-27 (2004) [B1]
Co-authors Roger Smith
2000 Smith R, Changs E-C, Mesiano S, Nicholson R, Cheng Y-H, Bowman M, et al., 'Regulation of parturition: The role of CRH', Hormones and Women's Health The Reproductive Years, Harwood Academic Publishers, Amsterdam, The Netherlands 215-219 (2000) [B1]
Co-authors John Fitter, Maria Bowman, Roger Smith
Show 6 more chapters

Journal article (155 outputs)

Year Citation Altmetrics Link
2017 Clifton VL, Cuffe J, Moritz KM, Cole TJ, Fuller PJ, Lu NZ, et al., 'Review: The role of multiple placental glucocorticoid receptor isoforms in adapting to the maternal environment and regulating fetal growth', Placenta, 54 24-29 (2017)

© 2016 Elsevier Ltd The physiological mechanisms that confer different outcomes in morbidity and mortality of the fetus exposed to stressful environments may be driven by signifi... [more]

© 2016 Elsevier Ltd The physiological mechanisms that confer different outcomes in morbidity and mortality of the fetus exposed to stressful environments may be driven by significant differences in the expression and function of the placental glucocorticoid receptor (GR). The recent discovery that the placenta contains at least 8 different isoforms of the GR raises questions about the regulation and physiological relevance of the many GR variants expressed in the placenta. The current data also highlights that individual differences in glucocorticoid sensitivity, variations in the effect of different complications of pregnancy on birth outcomes and sex differences in the response to stress, may all be dependent on a specific GR isoform expression profile. This review will investigate the current state of knowledge of GR isoforms in the placenta and discuss the potential role of these multiple isoforms in regulating glucocorticoid sensitivity.

DOI 10.1016/j.placenta.2016.12.017
2017 Akison LK, Nitert MD, Clifton VL, Moritz KM, Simmons DG, 'Review: Alterations in placental glycogen deposition in complicated pregnancies: Current preclinical and clinical evidence', Placenta, 54 52-58 (2017)

© 2017 Normal placental function is essential for optimal fetal growth. Transport of glucose from mother to fetus is critical for fetal nutrient demands and can be stored in the ... [more]

© 2017 Normal placental function is essential for optimal fetal growth. Transport of glucose from mother to fetus is critical for fetal nutrient demands and can be stored in the placenta as glycogen. However, the function of this glycogen deposition remains a matter of debate: It could be a source of fuel for the placenta itself or a storage reservoir for later use by the fetus in times of need. While the significance of placental glycogen remains elusive, mounting evidence indicates that altered glycogen metabolism and/or deposition accompanies many pregnancy complications that adversely affect fetal development. This review will summarize histological, biochemical and molecular evidence that glycogen accumulates in a) placentas from a variety of experimental rodent models of perturbed pregnancy, including maternal alcohol exposure, glucocorticoid exposure, dietary deficiencies and hypoxia and b) placentas from human pregnancies with complications including preeclampsia, gestational diabetes mellitus and intrauterine growth restriction (IUGR). These pregnancies typically result in altered fetal growth, developmental abnormalities and/or disease outcomes in offspring. Collectively, this evidence suggests that changes in placental glycogen deposition is a common feature of pregnancy complications, particularly those associated with altered fetal growth.

DOI 10.1016/j.placenta.2017.01.114
2017 Meakin AS, Saif Z, Jones AR, Aviles PFV, Clifton VL, 'Review: Placental adaptations to the presence of maternal asthma during pregnancy', Placenta, 54 17-23 (2017)

© 2017 Elsevier Ltd Asthma is a highly prevalent chronic medical condition affecting an estimated 12% of pregnant, women each year, with prevalence of asthma greatest (up to 16%)... [more]

© 2017 Elsevier Ltd Asthma is a highly prevalent chronic medical condition affecting an estimated 12% of pregnant, women each year, with prevalence of asthma greatest (up to 16%) among the socially disadvantaged. Maternal asthma is associated with significant perinatal morbidity and mortality including preterm births, neonatal hospitalisations and low birthweight outcomes each year. We have identified that the placenta adapts to the presence of chronic, maternal asthma during pregnancy in a sex specific manner that may confer sex differences in fetal outcome. The male fetus was at greater risk of a poor outcome than a female fetus in the presence of maternal asthma and an acute inflammatory event such as an asthma exacerbation. This review will examine the role of sex specific differences in placental function on fetal growth and survival.

DOI 10.1016/j.placenta.2017.01.123
2017 Clifton VL, 'Preface', Placenta, 54 1 (2017)
DOI 10.1016/j.placenta.2017.02.002
2017 Gatford KL, Wooldridge AL, Kind KL, Bischof R, Clifton VL, 'Pre-birth origins of allergy and asthma', Journal of Reproductive Immunology, (2017)

© 2017 Elsevier B.V. Allergy is a chronic disease that can develop as early as infancy, suggesting that early life factors are important in its aetiology. Variable associations b... [more]

© 2017 Elsevier B.V. Allergy is a chronic disease that can develop as early as infancy, suggesting that early life factors are important in its aetiology. Variable associations between size at birth, a crude marker of the fetal environment, and allergy have been reported in humans and require comprehensive review. Associations between birth weight and allergy are however confounded in humans, and we and others have therefore begun exploring the effects of early life events on allergy in experimental models. In particular, we are using ovine models to investigate whether and how a restricted environment before birth protects against allergy, whether methyl donor availability contributes to allergic protection in IUGR, and why maternal asthma during pregnancy is associated with increased risks of allergic disease in children. We found that experimental intrauterine growth restriction (IUGR) in sheep reduced cutaneous responses to antigens in progeny, despite normal or elevated IgE responses. Furthermore, maternal methyl donor supplementation in late pregnancy partially reversed effects of experimental IUGR, consistent with the proposal that epigenetic pathways underlie some but not all effects of IUGR on allergic susceptibility. Ovine experimental allergic asthma with exacerbations reduces relative fetal size in late gestation, with some changes in immune populations in fetal thymus suggestive of increased activation. Maternal allergic asthma in mice also predisposes progeny to allergy development. In conclusion, these findings in experimental models provide direct evidence that a perturbed environment before birth alters immune system development and postnatal function, and provide opportunities to investigate underlying mechanisms and develop and evaluate interventions.

DOI 10.1016/j.jri.2017.07.002
2017 Schubert KO, Air T, Clark SR, Grzeskowiak LE, Miller E, Dekker GA, et al., 'Trajectories of anxiety and health related quality of life during pregnancy', PLoS ONE, 12 (2017)

© 2017 Schubert et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and r... [more]

© 2017 Schubert et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Anxiety and health related Quality of Life (HRQoL) have emerged as important mental health measures in obstetric care. Few studies have systematically examined the longitudinal trajectories of anxiety and HRQoL in pregnancy. Using a linear growth modeling strategy, we analyzed the course of State-Trait Anxiety Inventory (STAI)- and Short Form (36) Health Survey (SF-36) scores between the 12 th and the 36 th week of gestation, in a sample of 355 women. We additionally analyzed the impact of depressive symptoms and a chronic medical condition (asthma), on STAI and SF-36 trajectory curves. STAI scores remained stable throughout pregnancy. A previous history of anxiety increased the overall STAI scores. Asthma and depressive symptoms scores had no impact on the STAI trajectory. Physical SF-36 scores decreased over the course of pregnancy, whereas mental SF-36 trended towards improvement. Asthma reduced physical SF-36 overall. While high depressive symptoms decreased the overall mental SF-36, they were also significantly associated with mental SF-36 improvements over time. Anxiety symptoms are stable during pregnancy and are not modulated by depressive symptoms or asthma. Physical HRQoL declines in pregnancy. In contrast, mental HRQoL appears to improve, particularly in women with high initial levels of depressive symptoms.

DOI 10.1371/journal.pone.0181149
2017 Tucker J, Grzeskowiak L, Murphy EMA, Wilson A, Clifton VL, 'Do women of reproductive age presenting with pelvic floor dysfunction have undisclosed anal incontinence: A retrospective cohort study', Women and Birth, 30 18-22 (2017)

© 2016 Australian College of Midwives Background Indirect and direct trauma following vaginal birth can negatively impact on the pelvic floor function increasing the risk of anal... [more]

© 2016 Australian College of Midwives Background Indirect and direct trauma following vaginal birth can negatively impact on the pelvic floor function increasing the risk of anal incontinence. It is often difficult for women to openly disclose that they have anal incontinence and there are limited data collection tools available for the identification of these women in a clinical setting. Aim This study aims to describe the prevalence of undisclosed anal incontinence in antenatal and postnatal women with pelvic floor dysfunction. Methods Retrospective cohort study of 230 antenatal and postnatal women referred to a Continence Nursing Service in a large tertiary hospital in South Australia, Australia, with pelvic floor dysfunction. A criteria list was utilised to access the primary reason for referral, anal incontinence assessments and attendance to an appointme nt. Results Anal incontinence was identified in 26% of women (n¿=¿59). Anal incontinence was the primary reason for referral amongst 8 women, with the remaining 51 women identified as having anal incontinence following clinical screening via phone consultation. Eighty six percent of women stated they had not previously disclosed anal incontinence to health professionals. Overall, 71% of symptomatic women (n¿=¿28 antenatal and n¿=¿14 postnatal women) attended appointments to a service specialising in pelvic floor dysfunction. Conclusion Women presenting with urinary incontinence or other markers of pelvic floor dysfunction should be actively screened for anal incontinence as the prevalence of this condition is high amongst childbearing women.

DOI 10.1016/j.wombi.2016.05.009
2017 Buckberry S, Bianco-Miotto T, Bent SJ, Clifton V, Shoubridge C, Shankar K, Roberts CT, 'Placental transcriptome co-expression analysis reveals conserved regulatory programs across gestation', BMC Genomics, 18 (2017)

© 2017 The Author(s). Background: Mammalian development in utero is absolutely dependent on proper placental development, which is ultimately regulated by the placental genome. T... [more]

© 2017 The Author(s). Background: Mammalian development in utero is absolutely dependent on proper placental development, which is ultimately regulated by the placental genome. The regulation of the placental genome can be directly studied by exploring the underlying organisation of the placental transcriptome through a systematic analysis of gene-wise co-expression relationships. Results: In this study, we performed a comprehensive analysis of human placental co-expression using RNA sequencing and intergrated multiple transcriptome datasets spanning human gestation. We identified modules of co-expressed genes that are preserved across human gestation, and also identifed modules conserved in the mouse indicating conserved molecular networks involved in placental development and gene expression patterns more specific to late gestation. Analysis of co-expressed gene flanking sequences indicated that conserved co-expression modules in the placenta are regulated by a core set of transcription factors, including ZNF423 and EBF1. Additionally, we identified a gene co-expression module enriched for genes implicated in the pregnancy pathology preeclampsia. By using an independnet transcriptome dataset, we show that these co-expressed genes are differentially expressed in preeclampsia. Conclusions: This study represents a comprehensive characterisation of placental co-expression and provides insight into potential transcriptional regulators that govern conserved molecular programs fundamental to placental development.

DOI 10.1186/s12864-016-3384-9
Citations Scopus - 1
2017 Hodyl NA, Aboustate N, Bianco-Miotto T, Roberts CT, Clifton VL, Stark MJ, 'Child neurodevelopmental outcomes following preterm and term birth: What can the placenta tell us?', Placenta, 57 79-86 (2017)

© 2017 Elsevier Ltd A significant proportion of children born preterm will experience some level of neurodevelopmental impairment. Changes in placental function have been observe... [more]

© 2017 Elsevier Ltd A significant proportion of children born preterm will experience some level of neurodevelopmental impairment. Changes in placental function have been observed with many antenatal conditions that are risk factors for preterm birth and/or poor neurodevelopment including fetal growth restriction and in-utero inflammation. This review will highlight placental factors that have been studied to understand the underlying mechanisms and identify biomarkers that lead to poor child neurodevelopmental outcomes. These include changes in gross morphological and histopathological structure and the placental inflammatory response to prenatal infection. Further, we will describe the placenta's role as both a barrier to maternally-derived bioactive substances critical for normal fetal brain development, such as cortisol, and a source of neuroactive steroids and neurotrophins known to have critical functions in neuronal proliferation, axonal growth, myelination and the regulation of apoptosis. Finally, emerging data supporting the potential utility of novel placental biomarkers in the early prediction of poor neurodevelopmental outcome in infants born both preterm and term will be discussed. These include the assessment of genetic variants (e.g. single nucleotide polymorphisms in placental tissue) and epigenetic biomarkers (e.g. placental microRNAs and placental DNA methylation). With the placenta the key tissue regulating the fetal environment, integration of observed changes in placental function with genetic and epigenetic variations may advance our ability to predict future infant health. Ultimately, this may facilitate targeted allocation of health resources with the aim of improving lifelong neurodevelopmental capability.

DOI 10.1016/j.placenta.2017.06.009
2017 Grzeskowiak LE, Clifton VL, 'Authors' reply re: Antidepressant use in late gestation and risk of postpartum haemorrhage: a retrospective cohort study', BJOG: An International Journal of Obstetrics and Gynaecology, 124 1284-1285 (2017)
DOI 10.1111/1471-0528.14606
2017 Adibi J, Burton GJ, Clifton V, Collins S, Frias AE, Gierman L, et al., 'IFPA meeting 2016 workshop report II: Placental imaging, placenta and development of other organs, sexual dimorphism in placental function and trophoblast cell lines', Placenta, (2017)

© 2017 Elsevier Ltd. Workshops are an important part of the IFPA annual meeting as they allow for discussion of specialized topics. At IFPA meeting 2016 there were twelve themed ... [more]

© 2017 Elsevier Ltd. Workshops are an important part of the IFPA annual meeting as they allow for discussion of specialized topics. At IFPA meeting 2016 there were twelve themed workshops, four of which are summarized in this report. These workshops addressed challenges, strengths and limitations of techniques and model systems for studying the placenta, as well as future directions for the following areas of placental research: 1) placental imaging; 2) sexual dimorphism; 3) placenta and development of other organs; 4) trophoblast cell lines.

DOI 10.1016/j.placenta.2017.02.021
2016 Wright IMR, Latter JL, Dyson RM, Levi CR, Clifton VL, 'Videomicroscopy as a tool for investigation of the microcirculation in the newborn', PHYSIOLOGICAL REPORTS, 4 (2016) [C1]
DOI 10.14814/phy2.12941
Citations Scopus - 1Web of Science - 1
Co-authors Joanna Latter, Ian Wright, Christopher Levi
2016 Vannuccini S, Lazzeri L, Orlandini C, Tosti C, Clifton VL, Petraglia F, 'Potential influence of in utero and early neonatal exposures on the later development of endometriosis', Fertility and Sterility, 105 997-1002 (2016)

© 2016 by American Society for Reproductive Medicine. Objective To investigate the possible correlation between maternal characteristics, in utero and early neonatal life exposur... [more]

© 2016 by American Society for Reproductive Medicine. Objective To investigate the possible correlation between maternal characteristics, in utero and early neonatal life exposures, and the development of endometriosis in adult life. Design Case-control study. Setting University hospital. Patient(s) A group of 161 patients with endometriosis and a control group of 230 women undergoing laparoscopy for benign adnexal diseases and free of endometriosis. Intervention(s) All women included in the study were requested to answer a series of questions about their mothers' gestational data and on their own perinatal and early postnatal lives. Main Outcome Measure(s) Odds ratio, adjusted odds ratios, and 95% confidence intervals for the associations between maternal characteristics during the patient's pregnancy, in utero exposure to obstetrical and perinatal complications, and the type of feeding received during the neonatal period with the development of endometriosis in adult life. Result(s) Mothers of women with endometriosis were significantly more likely to be affected by endometriosis or uterine fibroids, with a higher incidence of smoking during pregnancy. Women with endometriosis were more frequently born prematurely, with a significantly lower birth weight, and their mothers experienced preeclampsia during their pregnancies more often than control subjects. They were also more frequently formula fed than breast fed in early life. However, only prematurity and formula feeding were retained in the multivariate analysis model. Conclusion(s) Among intrauterine and early neonatal exposures, prematurity and formula feeding were risk factors for the development of endometriosis in adult life. Further studies should evaluate the underlying biologic mechanisms.

DOI 10.1016/j.fertnstert.2015.12.127
Citations Scopus - 3
2016 Clifton VL, Moss TJM, Wooldridge AL, Gatford KL, Liravi B, Kim D, et al., 'Development of an experimental model of maternal allergic asthma during pregnancy', Journal of Physiology, 594 1311-1325 (2016)

© 2016 The Physiological Society. Maternal asthma during pregnancy adversely affects pregnancy outcomes but identification of the cause/s, and the ability to evaluate interventio... [more]

© 2016 The Physiological Society. Maternal asthma during pregnancy adversely affects pregnancy outcomes but identification of the cause/s, and the ability to evaluate interventions, is limited by the lack of an appropriate animal model. We therefore aimed to characterise maternal lung and cardiovascular responses and fetal-placental growth and lung surfactant levels in a sheep model of allergic asthma. Immune and airway functions were studied in singleton-bearing ewes, either sensitised before pregnancy to house dust mite (HDM, allergic, n = 7) or non-allergic (control, n = 5), and subjected to repeated airway challenges with HDM (allergic group) or saline (control group) throughout gestation. Maternal lung, fetal and placental phenotypes were characterised at 140 ± 1 days gestational age (term, ~147 days). The eosinophil influx into lungs was greater after HDM challenge in allergic ewes than after saline challenge in control ewes before mating and in late gestation. Airway resistance increased throughout pregnancy in allergic but not control ewes, consistent with increased airway smooth muscle in allergic ewes. Maternal allergic asthma decreased relative fetal weight (-12%) and altered placental phenotype to a more mature form. Expression of surfactant protein B mRNA was 48% lower in fetuses from allergic ewes than controls, with a similar trend for surfactant protein D. Thus, allergic asthma in p regnant sheep modifies placental phenotype, and inhibits fetal growth and lung development consistent with observations from human pregnancies. Preconceptional allergen sensitisation and repeated airway challenges in pregnant sheep therefore provides an animal model to identify mechanisms of altered fetal development and adverse pregnancy outcomes caused by maternal asthma in pregnancy.

DOI 10.1113/JP270752
Citations Scopus - 3
2016 Sadovsky Y, Clifton VL, Knöfler M, 'Editorial: ZIKA virus and placenta', Placenta, 40 A1 (2016)
DOI 10.1016/j.placenta.2016.03.008
Citations Scopus - 6
2016 Grzeskowiak LE, Smith B, Roy A, Dekker GA, Clifton VL, 'An observational study of the impact of an antenatal asthma management service on asthma control during pregnancy', European Journal of Obstetrics Gynecology and Reproductive Biology, 197 48-53 (2016)

© 2015 Elsevier Ireland Ltd. Objective We sought to investigate the impact of introducing an antenatal asthma management service (AMS) on asthma control during pregnancy and subs... [more]

© 2015 Elsevier Ireland Ltd. Objective We sought to investigate the impact of introducing an antenatal asthma management service (AMS) on asthma control during pregnancy and subsequent perinatal outcomes. Study design Prospective, observational cohort study of pregnant asthmatic women attending a tertiary hospital antenatal clinic. Asthmatic women were recruited from the antenatal clinic and were followed prospectively with visits at 12, 20, 28 and 36 weeks gestation. A new nurse-led AMS was introduced offering asthma self-management education and support. Outcomes were compared between women recruited before and after the AMS was introduced (n = 89 and 80, respectively) and included; prevalence of exacerbations during pregnancy, asthma control throughout pregnancy and perinatal outcomes, including preterm birth and small-for-gestational-age (SGA). Results The relative risk for exacerbations (0.69; CI: 0.33-1.42), loss of control (0.67; CI 0.46-0.99) and persistent uncontrolled asthma (0.48; CI 0.26-0.9) were all reduced with attendance to AMS during pregnancy. AMS was associated with non-statistically significant reductions in asthma exacerbations (19.1-15.0%; p = 0.480) and uncontrolled asthma at =2 study visits (21.3-11.3%; p = 0.078). Conclusions These findings demonstrate the potential impact of an AMS in improving asthma control during pregnancy, supporting the need for an adequately powered RCT to determine its clinical- and cost-effectiveness.

DOI 10.1016/j.ejogrb.2015.11.038
Citations Scopus - 3
2016 McBain RD, Dekker GA, Clifton VL, Mol BW, Grzeskowiak LE, 'Impact of inter-pregnancy BMI change on perinatal outcomes: a retrospective cohort study', European Journal of Obstetrics Gynecology and Reproductive Biology, 205 98-104 (2016)

© 2016 Elsevier Ireland Ltd Objective To examine the patterns and predictors of inter-pregnancy body mass index (BMI) change and its impact on perinatal outcomes in the second pr... [more]

© 2016 Elsevier Ireland Ltd Objective To examine the patterns and predictors of inter-pregnancy body mass index (BMI) change and its impact on perinatal outcomes in the second pregnancy. Design Retrospective cohort study. Setting Tertiary teaching hospital in Adelaide, Australia. Population Women with their first and second consecutive, singleton deliveries occurring between 2000 and 2012 (N¿=¿5371). Methods Inter-pregnancy weight change calculated based on difference between BMI at respective antenatal booking visits. Association between inter-pregnancy weight change and perinatal outcomes investigated using multivariate generalised linear models, with stratification according to initial maternal BMI category in first pregnancy. Main outcome measures Gestational diabetes (GDM); pregnancy induced hypertensive disorders; small-for-gestational age (SGA); preterm birth; large-for-gestational age (LGA) and macrosomia ( > 4500¿g). Results On average, women with a normal BMI gained 1¿kg/m 2 between first and second pregnancies, while women who were overweight or obese gained 1.37¿kg/m 2 . Among women with a normal BMI in their first pregnancy, a BMI increase of =4¿kg/m 2 was associated with increased risk of developing GDM (aRR 1.97; 95% CI 1.22¿3.19), a macrosomic (aRR 4.06; 95% CI 2.25¿7.34) or LGA infant (aRR 1.31 0.96¿1.78) in the second pregnancy, while a reduction in BMI (=¿2¿kg/m 2 ) was associated with an increased risk of SGA (aRR 1.94; 1.19¿3.16). Among women who were overweight or obese in their first pregnancy, a BMI increase of =2¿4 and =4¿kg/m 2 was associated with increased risks of developing GDM in the second pregnancy (aRR 1.39; 95% CI 1.01¿1.91 and aRR 1.64 95% CI 1.16¿2.31; p trend ¿ < ¿0.001), while no associations were observed for a BMI increase and risk of a macrosomic, SGA, or LGA infant. In contrast, reduction in BMI (=¿2¿kg/m 2 ) was associated with a reduced risk of GDM (aRR 0.58 95% CI 0.37¿0.90) and SGA (aRR 0.47; 95% CI 0.25¿0.87). Conclusion Increases in BMI between pregnancies is associated with an increased risk for perinatal complications, even in normal-weight women, while a reduction in BMI is associated with improved perinatal outcomes among women who are overweight/obese. Inter-pregnancy weight control is an important target to reduce the risk of an adverse perinatal outcome in a subsequent pregnancy.

DOI 10.1016/j.ejogrb.2016.07.487
2016 Grieger JA, Clifton VL, Tuck AR, Wooldridge AL, Robertson SA, Gatford KL, 'In utero Programming of Allergic Susceptibility', International Archives of Allergy and Immunology, 169 80-92 (2016)

© 2016 S. Karger AG, Basel. Background: Around 30-40% of the world's population will experience allergy, the most common and earliest-onset noncommunicable disease. With a steady... [more]

© 2016 S. Karger AG, Basel. Background: Around 30-40% of the world's population will experience allergy, the most common and earliest-onset noncommunicable disease. With a steady rise in the incidence of allergic disease over recent decades, up to 18% of children will suffer a respiratory, food or skin allergy before their 18th birthday. There is compelling evidence that the risk of developing allergy is influenced by early life events and particularly in utero exposures. Methods: A comprehensive literature review was undertaken which outlines prenatal risk factors and potential mechanisms underlying the development of allergy in childhood. Results: Exposures including maternal cigarette smoking, preterm birth and Caesarean delivery are implicated in predisposing infants to the later development of allergy. In contrast, restricted growth in utero, a healthy maternal diet and a larger family size are protective, but the mechanisms here are unclear and require further investigation. Conclusion: To ameliorate the allergy pandemic in young children, we must define prenatal mechanisms that alter the programming of the fetal immune system and also identify specific targets for antenatal interventions.

DOI 10.1159/000443961
Citations Scopus - 4
2016 Vannuccini S, Clifton VL, Fraser IS, Taylor HS, Critchley H, Giudice LC, Petraglia F, 'Infertility and reproductive disorders: Impact of hormonal and inflammatory mechanisms on pregnancy outcome', Human Reproduction Update, 22 104-115 (2016)

© The Author 2015. Background: Reproductive disorders and infertility are associated with the risk of obstetric complications and have a negative impact on pregnancy outcome. Aff... [more]

© The Author 2015. Background: Reproductive disorders and infertility are associated with the risk of obstetric complications and have a negative impact on pregnancy outcome. Affected patients often require assisted reproductive technologies (ART) to conceive, and advanced maternal age is a further confounding factor. The challenge is to dissect causation, correlation and confounders in determining how infertility and reproductive disorders individually or together predispose women to poor pregnancy outcomes. methods: The published literature, to June 2015, was searched using PubMed, summarizing all evidences concerning the perinatal outcome of women with infertility and reproductive disorders and the potential mechanisms that may influence poor pregnancy outcome. Results: Reproductive disorders (endometriosis, adenomyosis, polycystic ovary syndrome and uterine fibroids) and unexplained infertility share inflammatory pathways, hormonal aberrations, decidual senescence and vascular abnormalities that may impair pregnancy success through common mechanisms. Either in combination or alone, these disorders results in an increased risk of preterm birth, fetal growth restriction, placental pathologies and hypertensive disorders. Systemic hormonal aberrations, and inflammatory and metabolic factors acting on endometrium, myometrium, cervix and placenta are all associated with an aberrant milieu during implantation and pregnancy, thus contributing to the genesis of obstetric complications. Some of these features have been also described in placentas from ART. Conclusions: Reproductive disorders arecommoninwomenof childbearing age and rarely occur in isolation. Inflammatory, endocrine and metabolic mechanisms associated with these disorders are responsible for an increased incidence of obstetric complications. These patients should be recognized as 'high risk' for poor pregnancy outcomes and monitored with specialized follow-up. There is a real need for development of evidence-based recommendations about clinical management and specific obstetric care pathways for the introduction of prompt preventative care measures.

DOI 10.1093/humupd/dmv044
Citations Scopus - 27
2016 Grzeskowiak LE, McBain R, Dekker GA, Clifton VL, 'Antidepressant use in late gestation and risk of postpartum haemorrhage: a retrospective cohort study', BJOG: An International Journal of Obstetrics and Gynaecology, 123 1929-1936 (2016)

© 2015 Royal College of Obstetricians and Gynaecologists Objective: To investigate the association between antidepressant use in late gestation and postpartum haemorrhage (PPH). ... [more]

© 2015 Royal College of Obstetricians and Gynaecologists Objective: To investigate the association between antidepressant use in late gestation and postpartum haemorrhage (PPH). Design: Retrospective cohort study. Setting: Tertiary teaching hospital in Adelaide, Australia. Population: A total of 30¿198 women delivering between 2002 and 2008. Methods: Relative risks adjusted for maternal sociodemographics and comorbidities (aRRs) were calculated for PPH, comparing women with late-gestation exposure to antidepressants (n¿=¿558), women with a psychiatric illness but no antidepressant use (n¿=¿1292), and women with neither antenatal exposures (n¿=¿28¿348). Additional sensitivity analyses were undertaken, examining associations with severe PPH and postpartum anaemia. Main outcome measures: The primary outcome was PPH, defined as a recorded blood loss of =500¿mL for vaginal deliveries and =1000¿mL for caesarean sections. Secondary outcomes included severe PPH (=1000¿mL blood loss, irrespective of method of delivery), and the presence of postpartum anaemia (identified from hospital medical records). Results: Compared with unexposed controls, women exposed to antidepressants had an increased risk of PPH (aRR¿1.53; 95% confidence interval, 95%¿CI 1.25¿1.86), whereas no increased risk was observed for women with a psychiatric illness but no antidepressant use (aRR¿1.04; 95%¿CI 0.89¿1.23). In sensitivity analyses, late gestation antidepressant exposure was associated with an increased risk of severe PPH (aRR¿1.84; 95%¿CI 1.39¿2.44), as well as postpartum anaemia (aRR¿1.80; 95%¿CI¿1.46¿2.22). Conclusions: Exposure to antidepressants in late gestation was associated with a significantly increased risk of PPH. Although potential confounding by unmeasured factors cannot be ruled out, these findings suggest a direct effect of antidepressant exposure on PPH. Tweetable abstract: Late gestation antidepressant exposure is associated with a significantly increased risk of postpartum haemorrhage.

DOI 10.1111/1471-0528.13612
Citations Scopus - 8
2016 Dickinson H, Davies-Tuck M, Ellery SJ, Grieger JA, Wallace EM, Snow RJ, et al., 'Maternal creatine in pregnancy: a retrospective cohort study', BJOG: An International Journal of Obstetrics and Gynaecology, 123 1830-1838 (2016)

© 2016 Royal College of Obstetricians and Gynaecologists Objective: To estimate creatine concentrations in maternal plasma and urine, and establish relationships with maternal ch... [more]

© 2016 Royal College of Obstetricians and Gynaecologists Objective: To estimate creatine concentrations in maternal plasma and urine, and establish relationships with maternal characteristics, diet and fetal growth. Design: Retrospective cohort study. Setting: Lyell McEwin Hospital, Adelaide, Australia. Population: A biobank of plasma and urine samples collected at 13, 18, 30 and 36¿weeks¿ gestation from 287 pregnant women from a prospective cohort of asthmatic and non-asthmatic women. Methods: Creatine was measured by enzymatic analysis. Change in creatine over pregnancy was assessed using the Friedman test. Linear mixed models regression was used to determine associations between maternal factors and diet with creatine across pregnancy and between creatine with indices of fetal growth at birth. Main outcome measures: Maternal creatine concentrations, associations between maternal factors and creatine and between creatine and fetal growth parameters. Results: Maternal smoking, body mass index, asthma and socio-economic status were positively and parity negatively associated with maternal plasma and/or urine creatine. Maternal urine creatine concentration was positively associated with birthweight centile and birth length. After adjustment, each µmol/l increase in maternal urinary creatine was associated with a 1.23 (95% CI 0.44¿2.02) unit increase in birthweight centile and a 0.11-cm (95% CI 0.03¿0.2) increase in birth length. Conclusions: Maternal factors and fetal growth measures are associated with maternal plasma and urine creatine concentrations. Tweetable abstract: Maternal creatine is altered by pregnancy; fetal growth measures are associated with maternal creatine concentrations.

DOI 10.1111/1471-0528.14237
Citations Scopus - 1
2016 Saif Z, Dyson RM, Palliser HK, Wright IMR, Lu N, Clifton VL, 'Identification of Eight Different Isoforms of the Glucocorticoid Receptor in Guinea Pig Placenta: Relationship to Preterm Delivery, Sex and Betamethasone Exposure', PLOS ONE, 11 (2016) [C1]
DOI 10.1371/journal.pone.0148226
Citations Scopus - 3Web of Science - 2
Co-authors Hannah Palliser, Ian Wright
2016 Grzeskowiak LE, Smith B, Roy A, Dekker GA, Clifton VL, 'Patterns, predictors and outcomes of asthma control and exacerbations during pregnancy: A prospective cohort study', ERS Monograph, 2 (2016)
DOI 10.1183/23120541.00054-2015
Citations Scopus - 5
2016 Grieger JA, Grzeskowiak LE, Wood LG, Clifton VL, 'Asthma control in pregnancy is associated with pre-conception dietary patterns', Public Health Nutrition, 19 332-338 (2016) [C1]

© 2015 The Authors. Objective To examine pre-conception dietary patterns in pregnant asthmatic women and to identify associations between maternal diet and asthma control during ... [more]

© 2015 The Authors. Objective To examine pre-conception dietary patterns in pregnant asthmatic women and to identify associations between maternal diet and asthma control during pregnancy. Design Cross-sectional study. Pre-conception food frequency data were collected retrospectively. Asthma control was assessed using the Global Initiative for Asthma guidelines. Dietary patterns were derived using factor analysis. Binary logistic regression analyses were used to test the association between uncontrolled asthma and each dietary pattern (Z-score), with values presented as odds ratio and 95 % confidence interval. Setting Antenatal clinic in a tertiary hospital, Adelaide, Australia, May 2009-July 2013. Subjects One hundred and fifty-eight asthmatic pregnant women. Results Three dietary patterns were identified: (i) 'high protein/fruit' (strong food group loadings for fish, meat, chicken, fruit); (ii) 'high fat/sugar/takeaway' (takeaway foods, crisps, refined grains); and (iii) 'vegetarian-type' (vegetables, fruit, soya milk, whole grains). A 1 sd increase in score on the high fat/sugar/takeaway pattern was associated with increased likelihood of uncontrolled asthma (adjusted OR=1·54; 95 % CI 1·07, 2·23; P=0·022). Women with uncontrolled asthma (n 115) had higher energy-adjusted intakes of saturated fat, monounsaturated fat, carbohydrate, sugar and fibre compared with women with controlled asthma (n 43, all P=0·05). Conclusions Pre-pregnancy dietary patterns may influence maternal asthma control. Our work highlights the importance of achieving a healthy diet before pregnancy that is low in saturated fat, sugar and takeaway foods, and therefore higher in lean meats, poultry and fish, as well as fruits, vegetables and whole grains. A healthy dietary pattern should be encouraged in all asthmatic women who are of childbearing age, and should additionally be promoted before pregnancy and beyond.

DOI 10.1017/S1368980015001226
Citations Scopus - 3Web of Science - 2
Co-authors Lisa Wood
2016 Mayne BT, Bianco-Miotto T, Buckberry S, Breen J, Clifton V, Shoubridge C, Roberts CT, 'Large scale gene expression meta-analysis reveals tissue-specific, sex-biased gene expression in humans', Frontiers in Genetics, 7 (2016)
DOI 10.3389/fgene.2016.00183
Citations Scopus - 2
2016 Grzeskowiak LE, Smith B, Roy A, Schubert KO, Baune BT, Dekker GA, Clifton VL, 'Impact of a history of maternal depression and anxiety on asthma control during pregnancy', Journal of Asthma, 1-8 (2016)

© 2017 Taylor & Francis Group, LLC Objective: To determine the impact of self-reported maternal depression/anxiety on asthma control during pregnancy. Method: Pregnant women wi... [more]

© 2017 Taylor & Francis Group, LLC Objective: To determine the impact of self-reported maternal depression/anxiety on asthma control during pregnancy. Method: Pregnant women with a doctor diagnosis of asthma (n = 189) were prospectively recruited at their antenatal booking visit, and the presence of maternal depression and anxiety was identified using self-report and routine questionnaire assessments. Data on exacerbations and asthma control were collected during gestation. Asthma control was assessed using the Juniper Asthma Control Questionnaire (ACQ) and women were classified as having recurrent uncontrolled asthma if their ACQ score was > 1.5 during two or more consecutive study visits. Exacerbations were defined as events that led to increased treatment requirements, and doctor or hospital visits. Results: There were 85 women with self-reported depression/anxiety and 104 women without self-reported depression/anxiety. The presence of depression/anxiety was associated with an increased likelihood (adjusted hazard ratio (HR) 1.67: 95% confidence interval (CI) 1.03¿2.72) and incidence (adjusted incidence rate ratio (IRR) 1.71: 95% CI 1.13¿2.58) of uncontrolled asthma during pregnancy, as well as an increased risk of recurrent uncontrolled asthma during 2 or more study visits (adjusted relative risk (RR) 1.98: 95% CI 1.00¿3.91). No impact of depression/anxiety was observed with respect to the likelihood (adjusted HR 0.70: 95% CI 0.35¿1.41) or incidence of exacerbations during pregnancy (adjusted IRR 0.66: 95% CI 0.35¿1.26). Conclusions: This study provides evidence that the presence of maternal depression/anxiety is associated with an increased likelihood and incidence of uncontrolled asthma during pregnancy. Given the high prevalence of co-morbid depression/anxiety among asthmatics, further research investigating such associations is urgently required.

DOI 10.1080/02770903.2016.1258080
2016 Corbisier De Meautsart C, Dyson RM, Latter JL, Berry MJ, Clifton VL, Wright IMR, 'Influence of sympathetic activity in the control of peripheral microvascular tone in preterm infants', Pediatric Research, 80 793-799 (2016) [C1]

Copyright © 2016 International Pediatric Research Foundation, Inc. Background:Microvascular dysregulation following preterm birth is associated with increased illness severity an... [more]

Copyright © 2016 International Pediatric Research Foundation, Inc. Background:Microvascular dysregulation following preterm birth is associated with increased illness severity and hypotension, particularly in males. Sympathetic nervous vascular regulation is evident in females. We hypothesized that sympathetic dysfu nction in male preterm infants may contribute to a failure of peripheral microvascular vasoconstriction.Methods:Microvascular blood flow of infants 24-43 wk gestational age was assessed at 6, 24, and 72 h of age by laser Doppler. Blood flow Fourier transformed frequency distribution spectra (low frequency/high frequency ratio) were used to assess the influence of sympathetic tone on microvascular regulation. Total sympathetic output was assessed as urinary normetanephrine.Results:Microvascular sympathetic activity at 24 h postnatal age decreased in early preterm males, but not females. Peripheral sympathetic activity increased with advancing postnatal age in females, but decreased in males. In early preterm infants, total normetanephrine outputs increase significantly with postnatal age, in both sexes.Conclusion:Sympathetic activation following preterm birth is sexually dimorphic, with preterm males having reduced sympathetic tone and reduced upregulation of sympathetic tone following birth. There is evidence of a disconnect between central sympathetic activity and local peripheral microcirculatory sympathetic drive. This may relate to autonomic nervous immaturity and highlights the need to understand how preterm birth may affect autonomic function.

DOI 10.1038/pr.2016.160
Co-authors Joanna Latter, Ian Wright
2016 Albrecht C, Caniggia I, Clifton V, Gohner C, Harris L, Hemmings D, et al., 'IFPA meeting 2015 workshop report III: nanomedicine applications and exosome biology, xenobiotics and endocrine disruptors and pregnancy, and lipid', PLACENTA, 48 S12-S16 (2016)
DOI 10.1016/j.placenta.2016.01.003
Co-authors Roger Smith
2015 Saif Z, Hodyl NA, Stark MJ, Fuller PJ, Cole T, Lu N, Clifton VL, 'Expression of eight glucocorticoid receptor isoforms in the human preterm placenta vary with fetal sex and birthweight', Placenta, 36 723-730 (2015)

© 2015 Elsevier Ltd. Introduction Administration of betamethasone to women at risk of preterm delivery is known to be associated with reduced fetal growth via alterations in plac... [more]

© 2015 Elsevier Ltd. Introduction Administration of betamethasone to women at risk of preterm delivery is known to be associated with reduced fetal growth via alterations in placental function and possibly direct effects on the fetus. The placental glucocorticoid receptor (GR) is central to this response and recent evidence suggests there are numerous isoforms for GR in term placentae. In this study we have questioned whether GR isoform expression varies in preterm placentae in relation to betamethasone exposure, fetal sex and birthweight. Methods Preterm (24-36 completed weeks of gestation, n = 55) and term placentae ( > 37 completed weeks of gestation, n = 56) were collected at delivery. Placental GR expression was examined using Western Blot and analysed in relation to gestational age at delivery, fetal sex, birthweight and betamethasone exposure. Data was analysed using non-parametric tests. Results Eight known isoforms of the GR were detected in the preterm placenta and include G Ra (94 kDa), GRß (91 kDa), GRa C (81 kDa) GR P (74 kDa) GR A (65 kDa), GRa D1-3 (50-55 kDa). Expression varied between preterm and term placentae with a greater expression of GRa C in preterm placentae relative to term placentae. The only sex differences in preterm placentae was that GRa D2 expression was higher in males than females. There were no alterations in preterm placental GR expression in association with betamethasone exposure. Discussion GRa C is the isoform involved in glucocorticoid induced apoptosis and suggests that its predominance in preterm placentae may contribute to the pathophysiology of preterm birth.

DOI 10.1016/j.placenta.2015.05.001
Citations Scopus - 14
2015 Wilmore M, Rodger D, Humphreys S, Clifton VL, Dalton J, Flabouris M, Skuse A, 'How midwives tailor health information used in antenatal care', Midwifery, 31 74-79 (2015)

© 2014 Elsevier Ltd. Objective: to examine the informal approaches taken by midwives and other antenatal staff to adapt health communication to the needs of their patients, as we... [more]

© 2014 Elsevier Ltd. Objective: to examine the informal approaches taken by midwives and other antenatal staff to adapt health communication to the needs of their patients, as well as their perception of the barriers faced when trying to provide tailored health promotion. Design: qualitative research methods (participant observation, individual and group interviews) were utilised to gain an understanding of how media and communication resources were used in practice within the study hospital. Setting: a major metropolitan teaching hospital located in the Northern suburbs of Adelaide, South Australia. Participants: individual semi-structured interviews with antenatal staff (n=8) were combined with group interviews (n=2; total number of staff=13), and observational research. Findings: midwives and other antenatal staff use a range of strategies to meet the perceived health literacy level of their patients. However, their attempts to tailor health information to individual needs are frequently based on incomplete information about patients' health literacy, may be inconsistent in delivery and content and are seldom assessed to determine whether communication has been understood or led to patient behaviour change. Key conclusions: midwives fully recognise the need to adapt standard printed materials to meet the diverse health literacy needs of patients but lack the resources required to evaluate whether these adaptations have positive effect. Implications for practice: midwives' commitment to improving health communication provides a latent resource that institutions can build on to improve health outcomes for patients with low health literacy. This requires improvements in health communication training, willingness to use a range of validated instruments for measuring health literacy, and commitment to use of innovative approaches to health promotion where these have been shown to have a positive impact on health behaviours.

DOI 10.1016/j.midw.2014.06.004
2015 Grzeskowiak LE, Clifton VL, 'Asthma management during pregnancy: How long before we can all breathe a little easier?', Journal of Asthma, 52 1020-1022 (2015)
DOI 10.3109/02770903.2015.1040494
Citations Scopus - 1
2015 Conti N, Torricelli M, Voltolini C, Vannuccini S, Clifton VL, Bloise E, Petraglia F, 'Term histologic chorioamnionitis: A heterogeneous condition', European Journal of Obstetrics Gynecology and Reproductive Biology, 188 34-38 (2015)

© 2015 Elsevier Ireland Ltd. All rights reserved. Abstract A histologic response of histologic chorioamnionitis (HCA) is defined as an intrauterine inflammatory condition charact... [more]

© 2015 Elsevier Ireland Ltd. All rights reserved. Abstract A histologic response of histologic chorioamnionitis (HCA) is defined as an intrauterine inflammatory condition characterized by acute granulocyte infiltratration into the fetal-maternal or the fetal tissues. Prevalence of HCA is inversely correlated with gestational age, occurring in 50% of preterm birth and in up to 20% of deliveries at term. Regardless of these standard definitions, understanding HCA is challenging as it reflects a heterogeneous condition. A histologic response of HCA from term placentas often does not correspond to a clinical presentation; in this context, the present review aims to analyze main characteristics of this condition, in particular focusing on mechanisms and birth outcomes.

DOI 10.1016/j.ejogrb.2015.02.034
Citations Scopus - 11
2015 Grzeskowiak LE, Hodyl NA, Stark MJ, Morrison JL, Clifton VL, 'Association of early and late maternal smoking during pregnancy with offspring body mass index at 4 to 5 years of age', Journal of Developmental Origins of Health and Disease, 6 485-492 (2015)

© 2015 Cambridge University Press and the International Society for Developmental Origins of Health and Disease. The objective was to investigate the association between early an... [more]

© 2015 Cambridge University Press and the International Society for Developmental Origins of Health and Disease. The objective was to investigate the association between early and late maternal smoking during pregnancy on offspring body mass index (BMI). We undertook a retrospective cohort study using linked records from the Women's and Children's Health Network in South Australia. Among a cohort of women delivering a singleton, live-born infants between January 2000 and December 2005 (n=7658), 5961 reported not smoking during pregnancy, 297 reported quitting smoking during the first trimester of pregnancy, and 1400 reported continued smoking throughout pregnancy. Trained nurses measured the height and weight of the children at preschool visits in a state-wide surveillance programme. The main outcome measure was age- and sex-specific BMI z-score. At 4 to 5 years, mean (s.d.) BMI z-score was 0.40 (1.05), 0.60 (1.07) and 0.65 (1.18) in children of mothers who reported never smoking, quitting smoking and continued smoking during pregnancy, respectively. Compared with the group of non-smokers, both quitting smoking and continued smoking were associated with an increase in child BMI z-score of 0.15 (95% confidence interval: 0.01-0.29) and 0.21 (0.13-0.29), respectively. A significant dose-response relationship was also observed between the number of cigarettes smoked per day on average during the second half of pregnancy and the increase in offspring BMI z-score (P < 0.001). In conclusion, any maternal smoking in pregnancy, even if mothers quit, is associated with an increase in offspring BMI at 4 to 5 years of age.

DOI 10.1017/S2040174415007151
Citations Scopus - 2
2015 Grieger JA, Clifton VL, 'A review of the impact of dietary intakes in human pregnancy on infant birthweight', Nutrients, 7 153-178 (2015)

© 2014 by the authors; licensee MDPI, Basel, Switzerland. Studies assessing maternal dietary intakes and the relationship with birthweight are inconsistent, thus attempting to dr... [more]

© 2014 by the authors; licensee MDPI, Basel, Switzerland. Studies assessing maternal dietary intakes and the relationship with birthweight are inconsistent, thus attempting to draw inferences on the role of maternal nutrition in determining the fetal growth trajectory is difficult. The aim of this review is to provide updated evidence from epidemiological and randomized controlled trials on the impact of dietary and supplemental intakes of omega-3 long-chain polyunsaturated fatty acids, zinc, folate, iron, calcium, and vitamin D, as well as dietary patterns, on infant birthweight. A comprehensive review of the literature was undertaken via the electronic databases Pubmed, Cochrane Library, and Medline. Included articles were those published in English, in scholarly journals, and which provided information about diet and nutrition during pregnancy and infant birthweight. There is insufficient evidence for omega-3 fatty acid supplements¿ ability to reduce risk of low birthweight (LBW), and more robust evidence from studies supplementing with zinc, calcium, and/or vitamin D needs to be established. Iron supplementation appears to increase birthweight, particularly when there are increases in maternal hemoglobin concentrations in the third trimester. There is limited evidence supporting the use of folic acid supplements to reduce the risk for LBW; however, supplementation may increase birthweight by ~130 g. Consumption of whole foods such as fruit, vegetables, low-fat dairy, and lean meats throughout pregnancy appears beneficial for appropriate birthweight. Intervention studies with an understanding of optimal dietary patterns may provide promising results for both maternal and perinatal health. Outcomes from these studies will help determine what sort of dietary advice could be promoted to women during pregnancy in order to promote the best health for themselves and their baby.

DOI 10.3390/nu7010153
Citations Scopus - 24
2015 Zouikr I, Ahmed AF, Horvat JC, Beagley KW, Clifton VL, Ray A, et al., 'Programming of formalin-induced nociception by neonatal LPS exposure: Maintenance by peripheral and central neuroimmune activity', Brain, Behavior, and Immunity, 44 235-246 (2015) [C1]

© 2014. The immune and nociceptive systems are shaped during the neonatal period where they undergo fine-tuning and maturation. Painful experiences during this sensitive period o... [more]

© 2014. The immune and nociceptive systems are shaped during the neonatal period where they undergo fine-tuning and maturation. Painful experiences during this sensitive period of development are known to produce long-lasting effects on the immune and nociceptive responses. It is less clear, however, whether inflammatory pain responses are primed by neonatal exposure to mild immunological stimuli, such as with lipopolysaccharide (LPS). Here, we examine the impact of neonatal LPS exposure on inflammatory pain responses, peripheral and hippocampal interleukin-1ß (IL-1ß), as well as mast cell number and degranulation in preadolescent and adult rats. Wistar rats were injected with LPS (0.05 mg/kg IP, Salmonella enteritidis) or saline on postnatal days (PNDs) 3 and 5 and later subjected to the formalin test at PNDs 22 and 80-97. At both time-points, and one-hour after formalin injection, blood and hippocampus were collected for measuring circulating and central IL-1ß levels using ELISA and Western blot, respectively. Paw tissue was also isolated to assess mast cell number and degree of degranulation using Toluidine Blue staining. Behavioural analyses indicate that at PND 22, LPS-challenged rats displayed enhanced flinching (p < .01) and licking (p < .01) in response to formalin injection. At PNDs 80-97, LPS-challenged rats exhibited increased flinching (p < .05), an effect observed in males only. Furthermore, neonatal LPS exposure enhanced circulating IL-1ß and mast cell degranulation in preadolescent but not adult rats following formalin injection. Hippocampal IL-1ß levels were increased in LPS-treated adult but not preadolescent rats in response to formalin injection. These data suggest neonatal LPS exposure produces developmentally regulated changes in formalin-induced behavioural responses, peripheral and central IL-1ß levels, as well as mast cell degranulation following noxious stimulation later in life. These findings highlight the importance of immune activation during the neonatal period in shaping immune response and pain sensitivity later in life. This is of clinical relevance given the high prevalence of bacterial infection during the neonatal period, particularly in the vulnerable population of preterm infants admitted to neonatal intensive care units.

DOI 10.1016/j.bbi.2014.10.014
Citations Scopus - 6Web of Science - 7
Co-authors Rick Thorne, Philip Hansbro, Jay Horvat, Deborah Hodgson
2015 Powell H, Murphy VE, Hensley MJ, Giles W, Clifton VL, Gibson PG, 'Rhinitis in pregnant women with asthma is associated with poorer asthma control and quality of life', Journal of Asthma, (2015) [C1]

© 2015 Taylor & Francis. Objective: To describe the pattern and severity of rhinitis in pregnancy and the impact rhinitis has on asthma control and quality of life (QoL) in pregn... [more]

© 2015 Taylor & Francis. Objective: To describe the pattern and severity of rhinitis in pregnancy and the impact rhinitis has on asthma control and quality of life (QoL) in pregnant women with asthma. Methods: Two hundred and eighteen non-smoking pregnant women with asthma were participants in a randomised controlled trial of exhaled nitric oxide guided treatment adjustment. Rhinitis was assessed using a visual analogue scale (VAS) scored from 0 to 10 and classified as current (VAS¿>¿2.5), moderate/severe versus mild (VAS¿>¿6 vs <5), atopic versus non-atopic and pregnancy rhinitis. At baseline, women completed the 20-Item Sino-Nasal Outcome Test (SNOT20), asthma-specific (AQLQ-M) QoL questionnaires and the Six-Item Short-Form State Trait Anxiety Inventory (STAI-6). Asthma control was assessed using the asthma control questionnaire (ACQ). Perinatal outcomes were collected after delivery. Results: Current rhinitis was present in 142 (65%) women including 45 (20%) women who developed pregnancy rhinitis. Women with current rhinitis had higher scores for ACQ (p¿=¿0.004), SNOT20 (p¿<¿0.0001) and AQLQ-M (p¿<¿0.0001) compared to women with no rhinitis. Current rhinitis was associated with increased anxiety symptoms (p¿=¿0.002), rhinitis severity was associated with higher ACQ score (p¿=¿0.004) and atopic rhinitis was associated with poorer lung function (p¿=¿0.037). Rhinitis symptom severity improved significantly during gestation (p¿<¿0.0001). There was no impact on perinatal outcomes. Improved asthma control was associated with improvement in rhinitis. Conclusion: Rhinitis in pregnant women with asthma is common and associated with poorer asthma control, sino-nasal and asthma-specific QoL impairment and anxiety. In the context of active asthma management there was significant improvement in rhinitis symptoms and severity as pregnancy progressed.

DOI 10.3109/02770903.2015.1054403
Citations Scopus - 3Web of Science - 4
Co-authors Vanessa Murphy, Peter Gibson, Michael Hensley
2014 Dyson RM, Palliser HK, Lakkundi A, de Waal K, Latter JL, Clifton VL, Wright IMR, 'Early microvascular changes in the preterm neonate: a comparative study of the human and guinea pig.', Physiol Rep, 2 (2014) [C1]
DOI 10.14814/phy2.12145
Co-authors Hannah Palliser, Joanna Latter, Ian Wright
2014 Grieger JA, Wood LG, Clifton VL, 'Antioxidant-rich dietary intervention for improving asthma control in pregnancies complicated by asthma: Study protocol for a randomized controlled trial', Trials, 15 (2014) [C3]

Background: Asthma is the most prevalent chronic disease to complicate pregnancies worldwide, affecting around 12% of pregnant women in Australia. Oxidative stress and inflammatio... [more]

Background: Asthma is the most prevalent chronic disease to complicate pregnancies worldwide, affecting around 12% of pregnant women in Australia. Oxidative stress and inflammation manifest during pregnancy; however asthma in pregnancies further intensifies oxidative stress. Consumption of antioxidant-rich foods has been shown to be beneficial for asthma control in non-pregnant asthmatic adults. It has not been investigated whether antioxidant-rich foods can improve the elevated oxidative stress that occurs with asthma in pregnancy, thereby improving asthma control. The primary aim of this study is to determine whether increased consumption of antioxidant-rich foods for 12 weeks will improve maternal asthma control, compared to standard dietary intake during pregnancy.Methods/design: A 12 week, parallel randomized controlled trial will be conducted. One hundred and sixty eight pregnant women with mild, moderate, or severe asthma, currently using inhaled corticosteroids, and with poor diet quality, will be recruited at approximately12 weeks gestation. Following a 4 week run-in period, women will be randomized to either a 12 week antioxidant intervention (increased consumption of antioxidant-rich foods (=5 servings/day vegetables, =2 servings/day fruit, =8 1-Feb servings/day grains (mostly wholegrains), 3-4 serving/week lean meat) or standard pregnancy care. The primary outcome is asthma control score (decrease of 0.5, the minimally clinically significant change). Secondary outcomes include plasma antioxidants, markers of oxidative stress, and time to, and number of, exacerbations. With two-tailed t-tests at 80% power, a sample size of 52 completions per group is required. Allowing for a 78% retention including a 20% removal of women from the analysis due to non-compliance, we will recruit 168 women.Discussion: It is expected that this 12 week study will improve asthma control. This is significant because asthma is the most prevalent condition to complicate pregnancies and contributes to poor maternal, neonatal and infant health outcomes. Our research will provide the first evidence to show that, in pregnancy, consumption of antioxidant-rich foods is a key modifier of clinical asthma status. This research is crucial for contributing to the evidence base to inform future guidelines given existing clinical and research gaps.Trial registration: ACTRN12613000301763. © 2014 Grieger et al.; licensee BioMed Central Ltd.

DOI 10.1186/1745-6215-15-108
Citations Scopus - 1Web of Science - 1
Co-authors Lisa Wood
2014 Zouikr I, Tadros MA, Barouei J, Beagley KW, Clifton VL, Callister RJ, Hodgson DM, 'Altered nociceptive, endocrine, and dorsal horn neuron responses in rats following a neonatal immune challenge', PSYCHONEUROENDOCRINOLOGY, 41 1-12 (2014) [C1]
DOI 10.1016/j.psyneuen.2013.11.016
Citations Scopus - 14Web of Science - 14
Co-authors Robert Callister, Deborah Hodgson
2014 Zouikr I, James MH, Campbell EJ, Clifton VL, Beagley KW, Dayas CV, Hodgson DM, 'Altered formalin-induced pain and fos induction in the periaqueductal grey of preadolescent rats following neonatal LPS exposure', PLoS ONE, 9 (2014) [C1]

Animal and human studies have demonstrated that early pain experiences can produce alterations in the nociceptive systems later in life including increased sensitivity to mechanic... [more]

Animal and human studies have demonstrated that early pain experiences can produce alterations in the nociceptive systems later in life including increased sensitivity to mechanical, thermal, and chemical stimuli. However, less is known about the impact of neonatal immune challenge on future responses to noxious stimuli and the reactivity of neural substrates involved in analgesia. Here we demonstrate that rats exposed to Lipopolysaccharide (LPS; 0.05 mg/kg IP, Salmonella enteritidis) during postnatal day (PND) 3 and 5 displayed enhanced formalin-induced flinching but not licking following formalin injection at PND 22. This LPS-induced hyperalgesia was accompanied by distinct recruitment of supraspinal regions involved in analgesia as indicated by significantly attenuated Fos-protein induction in the rostral dorsal periaqueductal grey (DPAG) as well as rostral and caudal axes of the ventrolateral PAG ( VLPAG). Formalin injections were associated with increased Fos-protein labelling in lateral habenula (LHb) as compared to medial habenula (MHb), however the intensity of this labelling did not differ as a result of neonatal immune challenge. These data highlight the importance of neonatal immune priming in programming inflammatory pain sensitivity later in development and highlight the PAG as a possible mediator of this process. © 2014 Zouikr et al.

DOI 10.1371/journal.pone.0098382
Citations Scopus - 8Web of Science - 8
Co-authors Christopher Dayas, Deborah Hodgson
2014 Tucker J, Clifton V, Wilson A, 'Teetering near the edge; Women's experiences of anal incontinence following obstetric anal sphincter injury: An interpretive phenomenological research study', Australian and New Zealand Journal of Obstetrics and Gynaecology, 54 377-381 (2014)

Background Obstetric anal sphincter injury (OASIS) following vaginal delivery increases the risk of anal incontinence (AI). Subsequent vaginal delivery and ageing increase the ris... [more]

Background Obstetric anal sphincter injury (OASIS) following vaginal delivery increases the risk of anal incontinence (AI). Subsequent vaginal delivery and ageing increase the risk of worsening symptoms. Very little literature describes any in-depth understanding of what it is like to live with AI following a history of known OASIS. Aim To describe and interpret women's experience of AI following OASIS and its impact on quality of life. Methods An interpretive phenomenological study was conducted in a level 2 tertiary hospital in South Australia. Women with a history of OASIS and AI were purposefully recruited. The St Marks Vaizey score was utilised to identify symptom severity. Semi-structured open-ended interviews were conducted, and data were analysed utilising Van Manen thematic analysis. Results Participants (n = 10) aged 26-56 years. All women were symptomatic of AI following OASIS, and 80% had received a primary OASIS at their first vaginal delivery. The St Marks Vaizey score mean was 9.1 (range within 4-22). Three essential themes grieving for loss, silence, striving for normality with eight subthemes identified a significant sense of loss and psychological impact of AI for this group of women. Conclusion Health professionals require a greater understanding of the negative impact of OASIS and AI on women's quality of life. This may improve the management, education and clinical care of this condition which may result as a consequence of OASIS. © 2014 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

DOI 10.1111/ajo.12230
Citations Scopus - 3
2014 Grieger JA, Grzeskowiak LE, Clifton VL, 'Preconception dietary patterns in human pregnancies are associated with preterm delivery', Journal of Nutrition, 144 1075-1080 (2014)

Maternal nutrition can have a profound effect on fetal growth, development, and subsequent infant birth weight. Preconception dietary patterns have not been assessed in relation t... [more]

Maternal nutrition can have a profound effect on fetal growth, development, and subsequent infant birth weight. Preconception dietary patterns have not been assessed in relation to perinatal outcomes. The objectives of this study were to identify associations between maternal dietary patterns in the 12 mo before conception on fetal growth and preterm delivery. Preconception food frequency data were collected retrospectively in 309 women. Dietary patterns were derived using factor analysis. Perinatal outcomes were collected at delivery with birth weight data calculated into percentiles to assess small and large for gestational age and preterm delivery at < 37 wk. Three dietary patterns were identified: 1) high-protein/fruit (characterized by fish, meat, chicken, fruit, and some whole grains); 2) high-fat/sugar/ takeaway (takeaway foods, potato chips, refined grains); and 3) vegetarian-type (vegetables, legumes, whole grains). A 1-SD increase in the scores on the high-protein/fruit pattern was associated with decreased likelihood of preterm birth (adjusted OR: 0.31; 95% CI: 0.13, 0.72; P = 0.007), whereas the reverse direction was apparent for the high-fat/sugar/takeaway pattern (adjusted OR: 1.54; 95% CI: 1.10, 2.15; P = 0.011). A 1-SD increase in the scores on the high fat/sugar/takeaway pattern was also associated with shorter gestation (adjusted regression coefficient: 22.7; 95% CI: 24.3, 21.1; P = 0.001) and birth length (adjusted regression coefficient: 20.5; 95% CI: 20.8, 20.1; P = 0.004). Nutrition before pregnancy is associated with perinatal outcomes. A dietary pattern containing several protein-rich food sources, fruit, and some whole grains is associated with reduced likelihood for preterm delivery, whereas a dietary pattern mainly consisting of discretionary items is associated with preterm delivery, shorter birth length, and earlier gestation. Poor dietary behaviors in the periconceptional period could be altered to promote behavior change in dietary intake to improve perinatal outcomes and the long-term health of the child. © 2014 American Society for Nutrition.

DOI 10.3945/jn.114.190686
Citations Scopus - 30
2014 Hodyl NA, Grzeskowiak LE, Stark MJ, Scheil W, Clifton VL, 'The impact of Aboriginal status, cigarette smoking and smoking cessation on perinatal outcomes in South Australia', Medical Journal of Australia, 201 274-278 (2014)

Objective: To assess the impact of Aboriginal status, active cigarette smoking and smoking cessation during pregnancy on perinatal outcomes. Design: Retrospective cohort study fro... [more]

Objective: To assess the impact of Aboriginal status, active cigarette smoking and smoking cessation during pregnancy on perinatal outcomes. Design: Retrospective cohort study from 1 January 1999 to 31 December 2008. Setting: All singleton births in South Australia. Participants: Population-based birth records of pregnancies to Aboriginal women (n = 4245) and non-Aboriginal women (n = 167 746). Main outcome measures: Adjusted odds ratios (aORs) and 95% CIs for adverse maternal and neonatal outcomes according to Aboriginal status and maternal smoking in pregnancy. Results: Active cigarette smoking during pregnancy was associated with an increased risk of adverse perinatal outcomes, including premature labour (Aboriginal, 1-10 cigarettes per day: aOR, 1.69; 95% CI, 1.28-2.23; non-Aboriginal, 1-10 cigarettes per day: aOR, 1.46; 95% CI, 1.34-1.58), preterm birth (Aboriginal, 1-10 cigarettes per day: aOR, 1.40; 95% CI, 1.14-1.73; non-Aboriginal, 1-10 cigarettes per day: aOR, 1.48; 95% CI, 1.39-1.57), intrauterine growth restriction (Aboriginal, 1-10 cigarettes per day: aOR, 2.33; 95% CI, 1.77-3.08; non-Aboriginal, 1-10 cigarettes per day: aOR, 2.65; 95% CI, 2.48-2.83) and small for gestational age (Aboriginal, 1-10 cigarettes per day: aOR, 2.49; 95% CI, 2.06-3.00; non-Aboriginal, 1-10 cigarettes per day: aOR, 2.29; 95% CI, 2.20-2.40). For both Aboriginal and non-Aboriginal women who smoked 11 or more cigarettes per day the aOR for these outcomes increased. Smoking cessation in the first trimester reduced these risks to levels comparable with non-smokers. The risk of each adverse outcome was greater in Aboriginal than non-Aboriginal women for all smoking categories; however, interactions between Aboriginal status and smoking were not significant, indicating an equal contribution of smoking to poor outcomes in both populations. Conclusions: Smoking cessation or reduction during pregnancy would significantly improve outcomes in both Aboriginal and non-Aboriginal women. This should be made a clear priority to improve pregnancy outcomes for all women.

DOI 10.5694/mja13.11142
Citations Scopus - 11
2014 Abumaree MH, Alahari S, Albrecht C, Aye ILMH, Bainbridge S, Chauvin S, et al., 'IFPA Meeting 2013 Workshop Report I: Diabetes in pregnancy, maternal dyslipidemia in pregnancy, oxygen in placental development, stem cells and pregnancy pathology', Placenta, 35 (2014)

Workshops are an important part of the IFPA annual meeting as they allow for discussion of specialized topics. At IFPA meeting 2013 there were twelve themed workshops, four of whi... [more]

Workshops are an important part of the IFPA annual meeting as they allow for discussion of specialized topics. At IFPA meeting 2013 there were twelve themed workshops, four of which are summarized in this report. These workshops related to various aspects of placental biology but collectively covered areas of pregnancy pathologies and placental metabolism: 1) diabetes in pregnancy; 2) lipids, fatty acids and the placenta; 3) oxygen in placental development and pathologies; 4) stem cells and pathologies. © 2013 Published by IFPA and Elsevier Ltd.

DOI 10.1016/j.placenta.2013.11.010
Citations Scopus - 2
2014 Saif Z, Hodyl NA, Hobbs E, Tuck AR, Butler MS, Osei-Kumah A, Clifton VL, 'The human placenta expresses multiple glucocorticoid receptor isoforms that are altered by fetal sex, growth restriction and maternal asthma', Placenta, 35 260-268 (2014)

Introduction We have previously identified sex-specific differences in the fetal-placental response to cortisol. Our recent studies suggest that this differential response to cort... [more]

Introduction We have previously identified sex-specific differences in the fetal-placental response to cortisol. Our recent studies suggest that this differential response to cortisol is driven by differences in glucocorticoid receptor (GR) protein function rather than through changes in gene transcription or protein expression. Methods This study was designed to define whether the human placenta expresses different isoforms of the GR and whether expression was altered by fetal sex and maternal asthma. Asthma and non-asthma pregnant women were prospectively recruited at their first antenatal visit and placentae collected at delivery. Placental GR expression was examined in relation to maternal asthma, fetal sex and birthweight. Results Twelve specific bands for the GR were identified at molecular weights of 94, 91, 81, 74, 69, 68, 65, 60, 55, 50, 48 and 38 kDa. The 12 isoforms were localised to the placental trophoblast and expression varied in relation to cellular location in either the cytoplasm or nucleus, fetal sex, fetal size and the presence and absence of maternal asthma. Conclusion This is the first study to identify the presence of several protein isoforms of the GR in the human placenta. The data suggest glucocorticoid resistance observed in male placentae may be mediated through increased GRß, GR A and GR P localisation to the nucleus. While female placentae may be more sensitive to cortisol in the presence of maternal asthma through a decrease in GRß and an enhancement GRa activity via an interaction with GRa D3 and GRa C. © 2014 Elsevier Ltd.

DOI 10.1016/j.placenta.2014.01.012
Citations Scopus - 27
2014 Sadovsky Y, Clifton VL, Burton GJ, 'Invigorating placental research through the "human Placenta Project"', Placenta, 35 527 (2014)
DOI 10.1016/j.placenta.2014.06.367
Citations Scopus - 4
2014 Burton GJ, Clifton V, Sadovsky Y, 'Congratulations!', Placenta, 35 973 (2014)
DOI 10.1016/j.placenta.2014.09.013
2014 Wooldridge AL, Bischof RJ, Meeusen EN, Liu H, Heinemann GK, Hunter DS, et al., 'Placental restriction of fetal growth reduces cutaneous responses to antigen after sensitization in sheep', American Journal of Physiology - Regulatory Integrative and Comparative Physiology, 306 (2014)

Prenatal and early childhood exposures are implicated as causes of allergy, but the effects of intrauterine growth restriction on immune function and allergy are poorly defined. W... [more]

Prenatal and early childhood exposures are implicated as causes of allergy, but the effects of intrauterine growth restriction on immune function and allergy are poorly defined. We therefore evaluated effects of experimental restriction of fetal growth on immune function and allergic sensitization in adolescent sheep. Immune function (circulating total red and white blood cells, neutrophils, lymphocytes, monocytes, eosinophils, and basophils, and the antibody response to Clostridial vaccination) and responses to house dust mite (HDM) allergen and ovalbumin (OVA) antigen sensitization (specific total Ig, IgG 1 , and IgE antibodies, and cutaneous hypersensitivity) were investigated in adolescent sheep from placentally restricted (PR, n = 23) and control (n = 40) pregnancies. Increases in circulating HDM-specific IgE (P = 0.007) and OVA-specific IgE (P = 0.038) were greater in PR than control progeny. PR did not alter total Ig, IgG 1 , or IgM responses to either antigen. PR increased OVA-specific but not HDM-specific IgA responses in females only (P = 0.023). Multiple birth increased Ig responses to OVA in a sex-specific manner. PR decreased the proportion of positive cutaneous hypersensitivity responders to OVA at 24 h (P = 0.030) but had no effect on cutaneous responses to HDM. Acute wheal responses to intradermal histamine correlated positively with birth weight in singletons (P = 0.023). Intrauterine growth restriction may suppress inflammatory responses in skin downstream of IgE induction, without impairment in antibody responses to a nonpolysaccharide vaccine. Discord between cutaneous and IgE responses following sensitization suggests new mechanisms for prenatal allergy programming. © 2014 the American Physiological Society.

DOI 10.1152/ajpregu.00432.2013
Citations Scopus - 9
2014 Hodyl NA, Stark MJ, Scheil W, Grzeskowiak LE, Clifton VL, 'Perinatal outcomes following maternal asthma and cigarette smoking during pregnancy', European Respiratory Journal, 43 704-716 (2014)

Does cigarette smoking in pregnancy explain the increased risk of adverse perinatal outcomes that occur with maternal asthma or does it compound the effect? Using population based... [more]

Does cigarette smoking in pregnancy explain the increased risk of adverse perinatal outcomes that occur with maternal asthma or does it compound the effect? Using population based birth records, a retrospective analysis was conducted of all singleton pregnancies in South Australia over 10 years (1999-2008; n5172 305), examining maternal asthma, cigarette smoking and quantity of smoking to estimate odds ratios. Compared with nonasthmatic females who did not smoke during pregnancy, both asthmatic females who smoked and those who did not smoke during pregnancy had a significantly increased risk of gestational diabetes, antepartum haemorrhage, polyhydramnios, premature rupture of membranes, emergency Caesarean section, and the child being small for gestational age and having congenital abnormalities. These associations suggest that asthma, independently of maternal smoking, increases the risk of these adverse perinatal outcomes. Maternal smoking was itself associated with an increased risk of a number of poor neonatal outcomes, with a dose-response relationship observed. Notably, maternal asthma combined with cigarette smoking significantly increased the risk of preterm birth and urinary tract infections to a greater degree than with either exposure alone. Maternal asthma and cigarette smoking during pregnancy are both independently associated with adverse perinatal outcomes and, combined, compound the risk of preterm birth and urinary tract infections.

DOI 10.1183/09031936.00054913
Citations Scopus - 15
2014 Dalton JA, Rodger DL, Wilmore M, Skuse AJ, Humphreys S, Flabouris M, Clifton VL, '"Who's afraid?": Attitudes of midwives to the use of information and communication technologies (ICTs) for delivery of pregnancy-related health information', Women and Birth, 27 168-173 (2014)

Background: Usage rates for information and communication technologies (ICTs) in healthcare have been increasing in recent years, but often lag behind general usage rates for popu... [more]

Background: Usage rates for information and communication technologies (ICTs) in healthcare have been increasing in recent years, but often lag behind general usage rates for populations as a whole. Research into such differential rates of ICT use across different segments of the population has identified a number of possible causal factors that limit usage. Aim: The research investigated midwives' attitudes and experiences of ICT use to identify potential causal factors that encourage or inhibit their usage in antenatal care. Methods: Semi-structured interviews, focus groups and short surveys were conducted with midwives who provide antenatal education at an Australian metropolitan hospital. Thematic and statistical analyses were used to interpret the data. Findings: Although midwives recognised the potential benefits of using ICTs to deliver pregnancy-related health information many had reservations about their use in everyday work. These reservations centred on lack of training in use of ICTs, the perceived legal risks associated with social media, potential violations of patient privacy, misdiagnosis and misunderstandings between midwife and client. Conclusion: Midwives face a number of barriers to effective use of ICTs in healthcare including material access, skills access, usage access and motivational access. Motivational access appears to be a key concern due to the high perception of risk associated with social media in particular. Reducing the motivational barriers through a range of interventions with midwifery staff may assist in overcoming other barriers to ICT use in antenatal care. Further research is required to determine whether these findings are generalisable to other healthcare contexts. © 2014 Australian College of Midwives.

DOI 10.1016/j.wombi.2014.06.010
Citations Scopus - 5
2014 Grzeskowiak LE, Dekker G, Rivers K, Roberts-Thomson K, Roy A, Smith B, et al., 'A randomized controlled trial to assess the clinical and cost effectiveness of a nurse-led Antenatal Asthma Management Service in South Australia (AAMS study)', BMC Pregnancy and Childbirth, 14 (2014)

Background: Pregnancy presents a unique situation for the management of asthma as it can alter the course of asthma severity and its treatment, which in turn can affect pregnancy ... [more]

Background: Pregnancy presents a unique situation for the management of asthma as it can alter the course of asthma severity and its treatment, which in turn can affect pregnancy outcomes. Despite awareness of the substantial adverse effects associated with asthma during pregnancy, little has been done to improve its management and reduce associated perinatal morbidity and mortality. The aim of this randomized controlled trial is to evaluate the clinical and cost effectiveness of an Antenatal Asthma Management Service.Methods/design: Design: Multicentre, randomized controlled trial. Inclusion criteria: Women with physician diagnosed asthma, which is not currently in remission, who are less than 20 weeks gestation with a singleton pregnancy and do not have a chronic medical condition. Trial entry and randomization: Eligible women with asthma, stratified by treatment site, disease severity and parity, will be randomized into either the 'Standard Care Group' or the 'Intervention Group'. Study groups: Both groups will be followed prospectively throughout pregnancy. Women in the 'Standard Care Group' will receive routine obstetric care reflecting current clinical practice in Australian hospitals. Women in the 'Intervention Group' will receive additional care through the nurse-led Antenatal Asthma Management Service, based in the antenatal outpatient clinic. Women will receive asthma education with a full assessment of their asthma at 18, 24, 30 and 36 weeks gestation. Each antenatal visit will include a 60 min session where asthma management skills are assessed including: medication adherence and knowledge, inhaler device technique, recognition of asthma deterioration and possession of a written asthma action plan. Furthermore, subjects will receive education about asthma control and management skills including trigger avoidance and smoking cessation counseling when appropriate. Primary study outcome: Asthma exacerbations during pregnancy. Sample size: A sample s ize of 378 women will be sufficient to show an absolute reduction in asthma exacerbations during pregnancy of 20% (alpha 0.05 two-tailed, 90% power, 5% loss to follow-up).Discussion: The integration of an asthma education program within the antenatal clinic setting has the significant potential to improve the participation of pregnant women in the self-management of their asthma, reduce asthma exacerbations and improve perinatal health outcomes.Trial registration: ACTRN12613000244707. © 2014 Grzeskowiak et al.; licensee BioMed Central Ltd.

DOI 10.1186/1471-2393-14-9
Citations Scopus - 4
2014 Bain E, Pierides KL, Clifton VL, Hodyl NA, Stark MJ, Crowther CA, Middleton P, 'Interventions for managing asthma in pregnancy', The Cochrane database of systematic reviews, 10 (2014)

BACKGROUND: Asthma is the most common respiratory disorder complicating pregnancy, and is associated with a range of adverse maternal and perinatal outcomes. There is strong evide... [more]

BACKGROUND: Asthma is the most common respiratory disorder complicating pregnancy, and is associated with a range of adverse maternal and perinatal outcomes. There is strong evidence however, that the adequate control of asthma can improve health outcomes for mothers and their babies. Despite known risks of poorly controlled asthma during pregnancy, a large proportion of women have sub-optimal asthma control, due to concerns surrounding risks of pharmacological agents, and uncertainties regarding the effectiveness and safety of different management strategies. OBJECTIVES: To assess the effects of interventions (pharmacologic and non-pharmacologic) for managing women's asthma in pregnancy on maternal and fetal/infant outcomes. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (2 June 2014) and the Cochrane Airways Group's Trials Register (4 June 2014). SELECTION CRITERIA: Randomised and quasi-randomised controlled trials comparing any intervention used to manage asthma in pregnancy, with placebo, no intervention, or an alternative intervention. We included pharmacological and non-pharmacological interventions (including combined interventions). Cluster-randomised trials were eligible for inclusion (but none were identified). Cross-over trials were not eligible for inclusion.We included multi-armed trials along with two-armed trials. We also included studies published as abstracts only. DATA COLLECTION AND ANALYSIS: At least two review authors independently assessed trial eligibility and quality and extracted data. Data were checked for accuracy. MAIN RESULTS: We included eight trials in this review, involving 1181 women and their babies. Overall we judged two trials to be at low risk of bias, two to be of unclear risk of bias, and four to be at moderate risk of bias.Five trials assessed pharmacological agents, including inhaled corticosteroids (beclomethasone or budesonide), inhaled magnesium sulphate, intravenous theophylline, and inhaled beclomethasone verus oral theophylline. Three trials assessed non-pharmacological interventions, including a fractional exhaled nitric oxide (FENO)-based algorithm versus a clinical guideline-based algorithm to adjust inhaled corticosteroid therapy, a pharmacist-led multi-disciplinary approach to management versus standard care, and progressive muscle relaxation (PMR) versus sham training.The eight included trials were assessed under seven separate comparisons. Pharmacological interventionsPrimary outcomes: one trial suggested that inhaled magnesium sulphate in addition to usual treatment could reduce exacerbation frequency in acute asthma (mean difference (MD) -2.80; 95% confidence interval (CI) -3.21 to -2.39; 60 women). One trial assessing the addition of intravenous theophylline to standard care in acute asthma did not report on exacerbations (65 women). No clear difference was shown in the risk of exacerbations with the use of inhaled beclomethasone in addition to usual treatment for maintenance therapy in one trial (risk ratio (RR) 0.36; 95% CI 0.13 to 1.05; 60 women); a second trial also showed no difference, however data were not clearly reported to allow inclusion in a meta-analysis. No difference was shown when inhaled beclomethasone was compared with oral theophylline for maintenance therapy (RR 0.88; 95% CI 0.59 to 1.33; one trial, 385 women). None of these trials reported on neonatal intensive care admissions. SECONDARY OUTCOMES: inhaled magnesium sulphate in acute asthma was shown to improve lung function measures (one trial, 60 women); intravenous theophylline in acute asthma was not associated with benefits (one trial, 65 women). No clear differences were seen with the addition of inhaled corticosteroids to routine treatment in three trials (374 women). While inhaled beclomethasone, compared with oral theophylline, significantly reduced treatment discontinuation due to adverse effects in one trial (384 women), no other differences wer...

DOI 10.1002/14651858.CD010660.pub2
Citations Scopus - 10
2013 Grieger JA, Wood LG, Clifton VL, 'Improving asthma during pregnancy with dietary antioxidants: The current evidence', Nutrients, 5 3212-3234 (2013) [C1]

The complication of asthma during pregnancy is associated with a number of poor outcomes for the mother and fetus. This may be partially driven by increased oxidative stress induc... [more]

The complication of asthma during pregnancy is associated with a number of poor outcomes for the mother and fetus. This may be partially driven by increased oxidative stress induced by the combination of asthma and pregnancy. Asthma is a chronic inflammatory disease of the airways associated with systemic inflammation and oxidative stress, which contributes to worsening asthma symptoms. Pregnancy alone also intensifies oxidative stress through the systemic generation of excess reactive oxidative species (ROS). Antioxidants combat the damaging effects of ROS; yet antioxidant defenses are reduced in asthma. Diet and nutrition have been postulated as potential factors to combat the damaging effects of asthma. In particular, dietary antioxidants may play a role in alleviating the heightened oxidative stress in asthma. Although there are some observational and interventional studies that have shown protective effects of antioxidants in asthma, assessment of antioxidants in pregnancy are limited and there are no antioxidant intervention studies in asthmatic pregnancies on asthma outcomes. The aims of this paper are to (i) review the relationships between oxidative stress and dietary antioxidants in adults with asthma and asthma during pregnancy, and (ii) provide the rationale for which dietary management strategies, specifically increased dietary antioxidants, might positively impact maternal asthma outcomes. Improving asthma control through a holistic antioxidant dietary approach might be valuable in reducing asthma exacerbations and improving asthma management during pregnancy, subsequently impacting perinatal health. © 2013 by the authors; licensee MDPI, Basel, Switzerland.

DOI 10.3390/nu5083212
Citations Scopus - 8Web of Science - 6
Co-authors Lisa Wood
2013 Burton GJ, Sadovsky Y, Clifton V, 'Prizes galore!', Placenta, 34 1 (2013)
DOI 10.1016/j.placenta.2012.11.031
2013 Powell H, McCaffery K, Murphy VE, Hensley MJ, Clifton VL, Giles W, Gibson PG, 'Psychosocial Variables Are Related to Future Exacerbation Risk and Perinatal Outcomes in Pregnant Women with Asthma', JOURNAL OF ASTHMA, 50 383-389 (2013) [C1]
DOI 10.3109/02770903.2012.757777
Citations Scopus - 21Web of Science - 19
Co-authors Peter Gibson, Michael Hensley, Vanessa Murphy
2013 Zouikr I, Tadros MA, Clifton VL, Beagley KW, Hodgson DM, 'Low Formalin Concentrations Induce Fine-Tuned Responses That Are Sex and Age-Dependent: A Developmental Study', PLOS ONE, 8 (2013) [C1]
DOI 10.1371/journal.pone.0053384
Citations Scopus - 6Web of Science - 7
Co-authors Deborah Hodgson
2013 Hodyl NA, Stark MJ, Butler M, Clifton VL, 'Placental P-glycoprotein is unaffected by timing of antenatal glucocorticoid therapy but reduced in SGA preterm infants', Placenta, 34 325-330 (2013)

Introduction: The beneficial effects of antenatal glucocorticoid therapy on fetal lung maturation require their passage across the placental glucocorticoid barrier, composed of gl... [more]

Introduction: The beneficial effects of antenatal glucocorticoid therapy on fetal lung maturation require their passage across the placental glucocorticoid barrier, composed of glucocorticoid metabolising enzymes, such as 11 beta hydroxysteroid dehydrogenase (11ßHSD), and proteins that efflux glucocorticoids, such as P-glycoprotein (P-gp). We have shown that 11ßHSD2 activity is responsive to antenatal glucocorticoids, however the effect on placental P-gp remains unknown. Since antenatal glucocorticoids have a greater prophylactic effect in females compared to males, we also assessed whether this therapy induced sexually dimorphic effects on P-gp expression, as well as on placental inflammatory processes mediated by corticosteroids. Methods: Placentas were collected from 53 women presenting in threatened preterm labour, and processed to assess cytokine and P-gp mRNA expression, as well as P-gp localisation using immunohistochemistry. Results: Placental cytokine, P-gp mRNA and protein expression were not altered by timing of antenatal glucocorticoids or fetal sex. However, both P-gp mRNA and protein expression were significantly reduced in placentas from infants born small for gestational age (SGA) compared to appropriately grown infants (p < 0.05), suggesting a role for P-gp in its pathogenesis via the provision of a net increase in fetal exposure to bioactive exogenous glucocorticoids. Conclusions: While this study identified no change in placental P-gp following antenatal glucocorticoids, it has provided evidence that P-gp plays an important role in cases of SGA. This supports the known mechanistic relationship between antenatal glucocorticoids, fetal development and the postnatal phenotype. Given that P-gp also confers fetal protection from a number of drugs, this finding warrants further investigation to improve clinical management of the SGA fetus. © 2013 Elsevier Ltd. All rights reserved.

DOI 10.1016/j.placenta.2013.01.013
Citations Scopus - 10
2013 Rodger D, Skuse A, Wilmore M, Humphreys S, Dalton J, Flabouris M, Clifton VL, 'Pregnant women's use of information and communications technologies to access pregnancy-related health information in South Australia', Australian Journal of Primary Health, 19 308-312 (2013)

This paper examines how pregnant women living in South Australia use information and communication technologies (ICTs), principally Internet and mobile phones, to access pregnancy... [more]

This paper examines how pregnant women living in South Australia use information and communication technologies (ICTs), principally Internet and mobile phones, to access pregnancy-related information. It draws on 35 semistructured interviews conducted as part of the 'Health-e Baby' project, a qualitative study designed to assess the information needs and ICT preferences of pregnant women cared for at a South Australian metropolitan teaching hospital. Our research shows that although ICTs offer exciting possibilities for health promotion and the potential for new forms of communication, networking and connection, we cannot assume the effectiveness of communicating through such channels, despite near universal levels of ICT access. In turn, this highlights that if e-mediated health promotion is to be effective, health promoters and practitioners need to better understand ICT access, usage and content preferences of their clients. © 2013 La Trobe University.

DOI 10.1071/PY13029
Citations Scopus - 13
2013 Stark MJ, Clifton VL, Hodyl NA, 'Differential effects of docosahexaenoic acid on preterm and term placental pro-oxidant/antioxidant balance', Reproduction, 146 243-251 (2013)

Docosahexaenoic acid (DHA) supplementation in pregnancy may confer some clinical benefits; however, this compound can exert pro-oxidant effects. In this study, we investigated the... [more]

Docosahexaenoic acid (DHA) supplementation in pregnancy may confer some clinical benefits; however, this compound can exert pro-oxidant effects. In this study, we investigated the effects of DHA on pro-oxidant/antioxidant balance in term and preterm placental explants, assessing oxidative stress marker concentrations, antioxidant capacity and pro-inflammatory cytokine production. Term (n=8) and preterm (n=9) placental explants were exposed to lipopolysaccharide (LPS, 1 ng/ml), DHA (1, 10 and 100 µM), and DHA and LPS simultaneously or pre-treated with DHA for 24 h prior to LPS treatment. The production of malondialdehyde (MDA, lipid peroxidation), 8-hydroxy-2-deoxy guanosine (8-OHdG, oxidative DNA damage) and pro-inflammatory cytokines (tumour necrosis factor a (TNFa), interleukin 6 and interferon-¿) and total antioxidant capacity were measured. DHA at a concentration of 100 µM induced oxidative stress in term placentas, while at all the three concentrations, it induced oxidative stress in preterm placentas. DHA and LPS resulted in reduced MDA levels in term (P < 0.005) and preterm (P=0.004) placentas and reduced 8-OHdG levels in preterm placentas (P=0.035). DHA pre-treatment, but not co-treatment with LPS, reduced 8-OHdG levels (P < 0.001) in term placentas. DHA increased antioxidant capacity only in term placentas (P < 0.001), with lower antioxidant capacity being observed overall in preterm placentas compared with term placentas (P=0.001). In term placentas, but not in preterm ones, DHA co-treatment and pre-treatment reduced LPS-induced TNFa levels. The ability of DHA to alter placental pro-oxidant/antioxidant balance is dependent on the DHA concentration used and the gestational age of the placental tissue. DHA has a greater capacity to increase oxidative stress in preterm placentas, but it offers greater protection against inflammation-induced oxidative stress in term placentas. This appears to be a result of DHA altering placental antioxidant capacity. These data have implications for the timing and concentration of DHA supplementation in pregnancy. © 2013 Society for Reproduction and Fertility.

DOI 10.1530/REP-13-0239
Citations Scopus - 6
2013 Tucker J, Wilson A, Clifton V, 'Women's experience of anal incontinence following a history of obstetric anal sphincter injury: A literature review', International Journal of Evidence-Based Healthcare, 11 181-186 (2013)

Background: Anal incontinence (AI) is the involuntary loss of a liquid or solid stool and flatus, resulting in a lifelong profound negative impact on a person's quality of life. O... [more]

Background: Anal incontinence (AI) is the involuntary loss of a liquid or solid stool and flatus, resulting in a lifelong profound negative impact on a person's quality of life. One million Australians, half of whom are women, are affected by AI. The aetiology of AI is reported within research literature. Importantly obstetric anal sphincter injury following vaginal delivery is a predominant cause of AI. Factors cited as major risk factors of anal sphincter damage include instrumental delivery, macrosomia and primiparity. The incidence of AI increases with age and with further vaginal delivery. The impact lasts for life. Aim: This study aims to identify women's experiences of AI following obstetric anal sphincter injury and their impact on quality of life. Method: An extensive online literature search was undertaken within the medical and nursing databases including the Cumulative Index of Nursing and Allied Health Literature, Scopus, PubMed and Medline. Key search terms included AI, faecal incontinence, anal sphincter injuries, obstetric complications, trauma, obstetric, postnatal care, experiences, women's experience and quality of life. The literature search was further refined through fields that included English language only, literature published between 2000 and 2012 and full-text articles. Findings: The review identified a significant amount of research literature that addressed the prevalence and cause of AI. While quality of life questionaries and symptom severity scores have been utilised to assess the impact of AI on a person's life, there are inherent weaknesses in providing the experience of AI on a person's life. Furthermore, there is limited in-depth research that addresses women's experiences of AI following a history of obstetric anal sphincter injury and the impact on their quality of life. Conclusion: Research findings contribute to understanding the prevalence, physical, social and emotional impact of AI. While alterations in clinical practice can improve the identification and management of AI, further research that builds on the state of knowledge and seeks a deeper understanding of the issues for women with AI as a result of obstetric anal sphincter injury is required. © 2013 The Authors International Journal of Evidence-Based Healthcare © 2013 The Joanna Briggs Institute.

DOI 10.1111/1744-1609.12025
Citations Scopus - 1
2013 Clifton VL, Hodyl NA, Fogarty PA, Torpy DJ, Roberts R, Nettelbeck T, et al., 'The impact of iodine supplementation and bread fortification on urinary iodine concentrations in a mildly iodine deficient population of pregnant women in South Australia', Nutrition Journal, 12 (2013)

Mild iodine deficiency during pregnancy can have significant effects on fetal development and future cognitive function. The purpose of this study was to characterise the iodine s... [more]

Mild iodine deficiency during pregnancy can have significant effects on fetal development and future cognitive function. The purpose of this study was to characterise the iodine status of South Australian women during pregnancy and relate it to the use of iodine-containing multivitamins. The impact of fortification of bread with iodized salt was also assessed. Women (n = 196) were recruited prospectively at the beginning of pregnancy and urine coll ected at 12, 18, 30, 36 weeks gestation and 6 months postpartum. The use of a multivitamin supplement was recorded at each visit. Spot urinary iodine concentrations (UIC) were assessed. Median UICs were within the mildly deficient range in women not taking supplements ( < 90 µg/L). Among the women taking iodine-containing multivitamins UICs were within WHO recommendations (150-249 µg/L) for sufficiency and showed an increasing trend through gestation. The fortification of bread with iodized salt increased the median UIC from 68 µg/L to 84 µg/L (p =.011) which was still in the deficient range. Pregnant women in this region of Australia were unlikely to reach recommended iodine levels without an iodine supplement, even after the mandatory iodine supplementation of bread was instituted in October 2009. © 2013 Clifton et al.; licensee BioMed Central Ltd.

DOI 10.1186/1475-2891-12-32
Citations Scopus - 18
2012 Wynne OL, Horvat JC, Smith R, Hansbro PM, Clifton VL, Hodgson DM, 'Effect of neonatal respiratory infection on adult BALB/c hippocampal glucocorticoid and mineralocorticoid receptors', Developmental Psychobiology, 54 568-575 (2012) [C1]
Citations Scopus - 2Web of Science - 2
Co-authors Philip Hansbro, Roger Smith, Deborah Hodgson, Olivia Wynne, Jay Horvat
2012 Tolosa Gonzalez JM, Schjenken JE, Clifton VL, Vargas A, Barbeau B, Lowry P, et al., 'The endogenous retroviral envelope protein syncytin-1 inhibits LPS/PHA-stimulated cytokine responses in human blood and is sorted into placental exosomes', Placenta, 33 933-941 (2012) [C1]
Citations Scopus - 43Web of Science - 40
Co-authors Roger Smith
2012 Sadovsky Y, Clifton VL, Burton GJ, 'The impact of impact factors', Placenta, 33 753 (2012)
DOI 10.1016/j.placenta.2012.07.006
2012 McLernon PC, Wood LG, Murphy VE, Hodyl NA, Clifton VL, 'Circulating antioxidant profile of pregnant women with asthma', Clinical Nutrition, 31 99-107 (2012) [C1]
Citations Scopus - 10Web of Science - 9
Co-authors Lisa Wood, Vanessa Murphy
2012 Clifton VL, Davies M, Moore V, Wright IM, Ali Z, Hodyl NA, 'Developmental perturbation induced by maternal asthma during pregnancy: The short- and long-term impacts on offspring', Journal of Pregnancy, 2012 1-8 (2012) [C1]
DOI 10.1155/2012/741613
Citations Scopus - 6
Co-authors Ian Wright
2012 McLernon PC, Wood LG, Murphy VE, Hodyl NA, Clifton VL, 'Fatty acid profile of pregnant women with asthma', e-SPEN Journal, 7 e78-e85 (2012) [C1]
DOI 10.1016/j.clnme.2012.01.004
Co-authors Vanessa Murphy, Lisa Wood
2012 Stark MJ, Hodyl NA, Butler M, Clifton VL, 'Localisation and characterisation of uncoupling protein-2 (UCP2) in the human preterm placenta', Placenta, 33 1020-1025 (2012)

The increase in oxidative stress during pregnancy is associated with increased placental antioxidant enzyme activity and may additionally be limited by the uncoupling proteins (UC... [more]

The increase in oxidative stress during pregnancy is associated with increased placental antioxidant enzyme activity and may additionally be limited by the uncoupling proteins (UCPs). There is little data on the expression and localisation of UCP2 in the human preterm placenta or on its role in the regulation of placental oxidative stress. Placentae were collected from women with singleton pregnancies who delivered between 24 and 36 weeks gestation (n = 54) and from a term reference group who delivered following uncomplicated pregnancy (n = 11). UCP2 expression and localisation was determined by quantitative real-time RTPCR using Taqman gene expression assays and immunohistochemistry. Placental lipid hydroperoxide and nitrotyrosine content was determined by ELISA. UCP2 mRNA expression increased from 24 to 41 weeks gestation (p < 0.001) and was positively correlated with placental weight (p = 0.004). While UCP2 expression was lower in small for gestational age infants (p = 0.045) it did not differ with respect to timing of antenatal betamethasone exposure nor with placental lipid hydroperoxide or nitrotyrosine content. UCP2 staining was identified in the cytotrophoblast in 34% of samples and in the syncytiotrophoblast in 63% of samples. Cytotrophoblast staining was more frequent in later gestations (p = 0.03) with syncytiotrophoblast UCP2 staining was not altered by gestation. In the preterm group, no association was observed with time since antenatal betamethasone exposure or placental lipid hydroperoxide or nitrotyrosine content. The current data supports gestation dependant alterations in UCP2 mRNA expression and immunohistochemical localisation in the human placenta but no evidence for an important role for UCP2 in protection against placental oxidative damage. © 2012 Elsevier Ltd. All rights reserved.

DOI 10.1016/j.placenta.2012.09.010
Citations Scopus - 3
2011 Stark MJ, Hodyl NA, Wright IM, Clifton V, 'The influence of sex and antenatal betamethasone exposure on vasoconstrictors and the preterm microvasculature', Journal of Maternal-Fetal & Neonatal Medicine, 24 1215-1220 (2011) [C1]
DOI 10.3109/14767058.2011.569618
Citations Scopus - 10Web of Science - 8
Co-authors Ian Wright
2011 Powell GH, Murphy VE, Taylor DR, Hensley MJ, McCaffery K, Giles W, et al., 'Management of asthma in pregnancy guided by measurement of fraction of exhaled nitric oxide: A double-blind, randomised controlled trial', The Lancet, 378 983-990 (2011) [C1]
DOI 10.1016/s0140-6736(11)60971-9
Citations Scopus - 148Web of Science - 133
Co-authors Peter Gibson, Michael Hensley, Vanessa Murphy
2011 Stark MJ, Hodyl NA, Wright IM, Clifton VL, 'Influence of sex and glucocorticoid exposure on preterm placental pro-oxidant-antioxidant balance', Placenta, 32 865-870 (2011) [C1]
DOI 10.1016/j.placenta.2011.08.010
Citations Scopus - 18Web of Science - 18
Co-authors Ian Wright
2011 Scott NM, Hodyl NA, Osei-Kumah A, Stark MJ, Smith R, Clifton VL, 'The presence of maternal asthma during pregnancy suppresses the placental pro-inflammatory response to an immune challenge in vitro', Placenta, 32 454-461 (2011) [C1]
Citations Scopus - 16Web of Science - 14
Co-authors Roger Smith
2011 Osei-Kumah A, Smith R, Jurisica I, Caniggia I, Clifton VL, 'Sex-specific differences in placental global gene expression in pregnancies complicated by asthma', Placenta, 32 570-578 (2011) [C1]
Citations Scopus - 37Web of Science - 39
Co-authors Roger Smith
2011 Powell H, McCaffery K, Murphy VE, Hensley MJ, Clifton VL, Giles WB, Gibson PG, 'Psychosocial outcomes are related to asthma control and quality of life in pregnant women with asthma', Journal of Asthma, 48 1032-1040 (2011) [C1]
DOI 10.3109/02770903.2011.631239
Citations Scopus - 27Web of Science - 26
Co-authors Peter Gibson, Vanessa Murphy, Michael Hensley
2011 Wynne OL, Horvat JC, Kim RY, Ong LK, Smith R, Hansbro PM, et al., 'Neonatal respiratory infection and adult re-infection: Effect on glucocorticoid and mineralocorticoid receptors in the hippocampus in BALB/c mice', Brain Behavior and Immunity, 25 1214-1222 (2011) [C1]
DOI 10.1016/j.bbi.2011.03.014
Citations Scopus - 3Web of Science - 3
Co-authors Olivia Wynne, Linkooi Ong, Philip Hansbro, Jay Horvat, Deborah Hodgson, Roger Smith
2011 Wynne OL, Horvat JC, Osei-Kumah A, Smith R, Hansbro PM, Clifton VL, Hodgson DM, 'Early life infection alters adult BALB/c hippocampal gene expression in a sex specific manner', Stress-the International Journal on the Biology of Stress, 14 247-261 (2011) [C1]
DOI 10.3109/10253890.2010.532576
Citations Scopus - 9Web of Science - 9
Co-authors Roger Smith, Philip Hansbro, Deborah Hodgson, Jay Horvat, Olivia Wynne
2011 Hodyl NA, Stark MJ, Osei-Kumah A, Bowman M, Gibson PG, Clifton VL, 'Fetal glucocorticoid-regulated pathways are not affected by inhaled corticosteroid use for asthma during pregnancy', American Journal of Respiratory and Critical Care Medicine, 183 716-722 (2011) [C1]
DOI 10.1164/rccm.201007-1188oc
Citations Scopus - 23Web of Science - 19
Co-authors Maria Bowman, Peter Gibson
2011 Zarzycki PK, Zarzycka MB, Clifton VL, Adamski J, Glód BK, 'Low-parachor solvents extraction and thermostated micro-thin-layer chromatography separation for fast screening and classification of spirulina from pharmaceutical formulations and food samples', Journal of Chromatography A, 1218 5694-5704 (2011)

The goal of this paper is to demonstrate the separation and detection capability of eco-friendly micro-TLC technique for the classification of spirulina and selected herbs from ph... [more]

The goal of this paper is to demonstrate the separation and detection capability of eco-friendly micro-TLC technique for the classification of spirulina and selected herbs from pharmaceutical and food products. Target compounds were extracted using relatively low-parachor liquids. A number of the spirulina samples which originated from pharmaceutical formulations and food products, were isolated using a simple one step extraction with small volume of methanol, acetone or tetrahydrofuran. Herb samples rich in chlorophyll dyes were analyzed as reference materials. Quantitative data derived from micro-plates under visible light conditions and after iodine staining were explored using chemometrics tools including cluster analysis and principal components analysis. Using this method we could easily distinguish genuine spirulina and non-spirulina samples as well as fresh from expired commercial products and furthermore, we could identify some biodegradation peaks appearing on micro-TLC profiles. This methodology can be applied as a fast screening or fingerprinting tool for the classification of genuine spirulina and herb samples and in particular may be used commercially for the rapid quality control screening of products. Furthermore, this approach allows low-cost fractionation of target substances including cyanobacteria pigments in raw biological or environmental samples for preliminary chemotaxonomic investigations. Due to the low consumption of the mobile phase (usually less than 1. mL per run), this method can be considered as environmentally friendly analytical tool, which may be an alternative for fingerprinting protocols based on HPLC machines and simple separation systems involving planar micro-fluidic or micro-chip devices. © 2011 Elsevier B.V.

DOI 10.1016/j.chroma.2011.06.065
Citations Scopus - 15
2011 Prescott SL, Tulic M, Osei-Kumah A, Richman T, Crook M, Martino D, et al., 'Reduced placental FOXP3 associated with subsequent infant allergic disease', Journal of Allergy and Clinical Immunology, 128 (2011)
DOI 10.1016/j.jaci.2011.05.017
Citations Scopus - 13
2011 Al-Khan A, Aye IL, Barsoum I, Borbely A, Cebral E, Cerchi G, et al., 'IFPA Meeting 2010 Workshops Report II: Placental pathology; trophoblast invasion; fetal sex; parasites and the placenta; decidua and embryonic or fetal loss; trophoblast differentiation and syncytialisation', Placenta, 32 (2011)

Workshops are an important part of the IFPA annual meeting. At IFPA Meeting 2010 diverse topics were discussed in twelve themed workshops, six of which are summarized in this repo... [more]

Workshops are an important part of the IFPA annual meeting. At IFPA Meeting 2010 diverse topics were discussed in twelve themed workshops, six of which are summarized in this report. 1. The placental pathology workshop focused on clinical correlates of placenta accreta/percreta. 2. Mechanisms of regulation of trophoblast invasion and spiral artery remodeling were discussed in the trophoblast invasion workshop. 3. The fetal sex and intrauterine stress workshop explored recent work on placental sex differences and discussed them in the context of whether boys live dangerously in the womb.4. The workshop on parasites addressed inflammatory responses as a sign of interaction between placental tissue and parasites. 5. The decidua and embryonic/fetal loss workshop focused on key regulatory mediators in the decidua, embryo and fetus and how alterations in expression may contribute to different diseases and adverse conditions of pregnancy. 6. The trophoblast differentiation and syncytialisation workshop addressed the regulation of villous cytotrophoblast differentiation and how variations may lead to placental dysfunction and pregnancy complications.

DOI 10.1016/j.placenta.2010.12.025
Citations Scopus - 16
2011 Hodyl NA, Stark MJ, Osei-Kumah A, Clifton VL, 'Prenatal programming of the innate immune response following in utero exposure to inflammation: A sexually dimorphic process?', Expert Review of Clinical Immunology, 7 579-592 (2011)

Maternal infection and inflammation are common events during pregnancy. This article documents evidence that suggests such inflammation compromises the development of the fetal in... [more]

Maternal infection and inflammation are common events during pregnancy. This article documents evidence that suggests such inflammation compromises the development of the fetal innate immune response, in support of an in utero origins hypothesis of neonatal and childhood inflammatory disease. The potential for this response to exhibit sex specificity is also explored, based on evidence of sexually dimorphic placental responses to maternal inflammation. © 2011 Expert Reviews Ltd.

DOI 10.1586/eci.11.51
Citations Scopus - 16
2010 Hodyl NA, Walker FR, Krivanek K, Clifton VL, Hodgson DM, 'Prenatal endotoxin exposure alters behavioural pain responses to lipopolysaccharide in adult offspring', Physiology & Behavior, 100 143-147 (2010) [C1]
DOI 10.1016/j.physbeh.2010.02.013
Citations Scopus - 6Web of Science - 7
Co-authors Rohan Walker, Deborah Hodgson
2010 Murphy VE, Clifton VL, Gibson PG, 'The effect of cigarette smoking on asthma control during exacerbations in pregnant women', Thorax, 65 739-744 (2010) [C1]
DOI 10.1136/thx.2009.124941
Citations Scopus - 33Web of Science - 28
Co-authors Vanessa Murphy, Peter Gibson
2010 Hodyl NA, Wyper HJ, Osei-Kumah A, Scott NM, Murphy VE, Gibson PG, et al., 'Sex-specific associations between cortisol and birth weight in pregnancies complicated by asthma are not due to differential glucocorticoid receptor expression', Thorax, 65 677-683 (2010) [C1]
DOI 10.1136/thx.2009.123091
Citations Scopus - 20Web of Science - 19
Co-authors Peter Gibson, Vanessa Murphy, Roger Smith
2010 Osei-Kumah A, Wark PA, Smith R, Clifton VL, 'Asthma during pregnancy alters immune cell profile and airway epithelial chemokine release', Inflammation Research, 59 349-358 (2010) [C1]
DOI 10.1007/s00011-009-0102-y
Citations Scopus - 8Web of Science - 6
Co-authors Peter Wark, Roger Smith
2010 Clifton VL, Hodyl NA, Murphy VE, Giles WB, Baxter RC, Smith R, 'Effect of maternal asthma, inhaled glucocorticoids and cigarette use during pregnancy on the newborn insulin-like growth factor axis', Growth Hormone and IGF Research, 20 39-48 (2010) [C1]
DOI 10.1016/j.ghir.2009.07.004
Citations Scopus - 24Web of Science - 19
Co-authors Roger Smith, Vanessa Murphy
2010 Lash GE, Burton GJ, Chamley LW, Clifton VL, Constancia M, Crocker IP, et al., 'IFPA Meeting 2009 Workshops Report', PLACENTA, 31 S4-S20 (2010)
DOI 10.1016/j.placenta.2009.12.008
Citations Scopus - 8Web of Science - 11
2010 Clifton VL, 'Review: Sex and the Human Placenta: Mediating Differential Strategies of Fetal Growth and Survival', Placenta, 31 (2010)

There are known sex specific differences in fetal and neonatal morbidity and mortality. There are also known differences in birthweight centile with males generally being larger t... [more]

There are known sex specific differences in fetal and neonatal morbidity and mortality. There are also known differences in birthweight centile with males generally being larger than females at birth. These differences are generally ignored when studying obstetric complications of pregnancy and the mechanisms that confer these differences between the sexes are unknown. Current evidence suggests sex specific adaptation of the placenta may be central to the differences in fetal growth and survival. Our research examining pregnancies complicated by asthma has reported sexually dimorphic differences in fetal growth and survival with males adapting placental function to allow for continued growth in an adverse maternal environment while females reduce growth in an attempt to survive further maternal insults. We have reported sex differences in placental cytokine expression, insulin-like growth factor pathways and the placental response to cortisol in relation to the complication of asthma during pregnancy. More recently we have identified sex specific alterations in placental function in pregnancies complicated by preterm delivery which were associated with neonatal outcome and survival. We propose the sexually dimorphic differences in growth and survival of the fetus are mediated by the sex specific function of the human placenta. This review will present evidence supporting this hypothesis and will argue that to ignore the sex of the placenta is no longer sound scientific practice. Crown Copyright © 2010.

DOI 10.1016/j.placenta.2009.11.010
Citations Scopus - 244
2010 Zarzycki PK, Zarzycka MB, Sla¸czka MM, Clifton VL, 'Acetonitrile, the polarity chameleon', Analytical and Bioanalytical Chemistry, 397 905-908 (2010)

Acetonitrile (CH 3 CN, ACN) is a relatively nontoxic, highly volatile and aprotic polar organic solvent. ACN plays a key role as an extraction and deproteinization medium for a va... [more]

Acetonitrile (CH 3 CN, ACN) is a relatively nontoxic, highly volatile and aprotic polar organic solvent. ACN plays a key role as an extraction and deproteinization medium for a variety of pre-purification and concentration techniques using liquid-liquid extraction, solid-phase extraction (SPE) or microextraction (SPME) protocols. In terms of polarity, acetonitrile shows a number of unexpected physicochemical properties that may strongly affect the final results of analytical protocols applied in detection and separation science. Strong hydrogen bonding and the creation of low-polar self-associated forms of acetonitrile affect a number of physical and chemical properties of acetonitrile-water mixtures. The relatively low polarity of pure ACN can easily be disrupted by the presence of a small amount of water, which is usually present in either the raw biological sample or the ACN itself. The phenomenon of acetonitrile-water phase splitting at subambient temperature provides a convenient way to deproteinize biological samples and to preconcentrate target analytes.

DOI 10.1007/s00216-010-3677-9
Citations Scopus - 11
2009 Clifton VL, Engel PJ, Smith R, Gibson PG, Brinsmead MW, Giles WB, 'Maternal and neonatal outcomes of pregnancies complicated by asthma in an Australian population', Australian and New Zealand Journal of Obstetrics and Gynaecology, 49 619-626 (2009) [C1]
DOI 10.1111/j.1479-828x.2009.01077.x
Citations Scopus - 35Web of Science - 35
Co-authors Peter Gibson, Roger Smith
2009 Scott NM, Hodyl NA, Murphy VE, Osei-Kumah A, Wyper H, Hodgson DM, et al., 'Placental cytokine expression covaries with maternal asthma severity and fetal sex', Journal of Immunology, 182 1411-1420 (2009) [C1]
Citations Scopus - 53Web of Science - 51
Co-authors Deborah Hodgson, Roger Smith, Vanessa Murphy
2009 Stark MJ, Clifton VL, Wright IM, 'Neonates born to mothers with preeclampsia exhibit sex-specific alterations in microvascular function', Pediatric Research, 65 291-295 (2009) [C1]
DOI 10.1203/PDR.0b013e318193edf1
Citations Scopus - 28Web of Science - 17
Co-authors Ian Wright
2009 Stark MJ, Clifton VL, Wright IM, 'Carbon monoxide is a significant mediator of cardiovascular status following preterm birth', Pediatrics, 124 277-284 (2009) [C1]
DOI 10.1542/peds.2008-0877
Citations Scopus - 16Web of Science - 15
Co-authors Ian Wright
2009 Stark MJ, Wright IM, Clifton VL, 'Sex-specific alterations in placental 11 beta-hydroxysteroid dehydrogenase 2 activity and early postnatal clinical course following antenatal betamethasone', American Journal of Physiology-Regulatory Integrative and Comparative Physiology, 297 R510-R514 (2009) [C1]
DOI 10.1152/ajpregu.00175.2009
Citations Scopus - 73Web of Science - 69
Co-authors Ian Wright
2009 Vu TT, Hirst JJ, Stark MJ, Wright IM, Palliser HK, Hodyl NA, Clifton VL, 'Changes in human placental 5 alpha-reductase isoenzyme expression with advancing gestation: Effects of fetal sex and glucocorticoid exposure', Reproduction Fertility and Development, 21 599-607 (2009) [C1]
DOI 10.1071/rd08224
Citations Scopus - 19Web of Science - 17
Co-authors Jon Hirst, Ian Wright, Hannah Palliser
2009 Prescott SL, Clifton V, 'Asthma and pregnancy: Emerging evidence of epigenetic interactions in utero', Current Opinion in Allergy and Clinical Immunology, 9 417-426 (2009)

PURPOSE OF REVIEW: Pregnancy is arguably the most critical period of developmental programming. Here, we particularly focus on the emerging paradigm that disease propensity is epi... [more]

PURPOSE OF REVIEW: Pregnancy is arguably the most critical period of developmental programming. Here, we particularly focus on the emerging paradigm that disease propensity is epigenetically determined by maternal exposures that have the capacity to activate or silence fetal genes through alterations in DNA and histone methylation, histone acetylation, and chromatin structure. RECENT FINDINGS: The most notable recent candidate to emerge in this role has been dietary folate, a methyl donor clearly associated with changes in gene expression and disease susceptibility through gene hypermethylation. Animal studies also provide the first evidence that the allergy protective effects of microbial exposure in pregnancy may be mediated by changes in methylation of Th1 genes of the offspring. There is also emerging evidence that perinatal differences in immune function of allergy-prone newborns extend beyond previously recognized differences in effector T cell (Th1/Th2) function, to also include differences in neonatal regulatory T cell (Treg) and Th17 function, and moreover, that these pathways are also epigenetically regulated. SUMMARY: New studies reinforce the importance of in-utero exposures (including dietary nutrients, microbial products, cigarette smoking, and certain maternal mediations) in fetal immune development and in programming the susceptibility to asthma and allergic disease. © 2009 Lippincott Williams & Wilkins, Inc.

DOI 10.1097/ACI.0b013e328330634f
Citations Scopus - 110
2008 Osei-Kumah A, Smith R, Clifton VL, 'Maternal and cord plasma cytokine and chemokine profile in pregnancies complicated by asthma', Cytokine, 43 187-193 (2008) [C1]
DOI 10.1016/j.cyto.2008.05.008
Citations Scopus - 10Web of Science - 9
Co-authors Roger Smith
2008 Stark MJ, Clifton VL, Wright IM, 'Microvascular flow, clinical illness severity and cardiovascular function in the preterm infant', Archives of Disease in Childhood Fetal & Neonatal Edition, 93 F271-F274 (2008) [C1]
DOI 10.1136/adc.2007.123539
Citations Scopus - 37Web of Science - 31
Co-authors Ian Wright
2008 Engel PJ, Smith R, Brinsmead MW, Bowe SJ, Clifton VL, 'Male sex and pre-existing diabetes are independent risk factors for stillbirth', Australian & New Zealand Journal of Obstetrics & Gynaecology, 48 375-383 (2008) [C1]
DOI 10.1111/j.1479-828x.2008.00863.x
Citations Scopus - 28Web of Science - 29
Co-authors Roger Smith
2008 Johnson RF, Rennie N, Murphy VE, Zakar T, Clifton VL, Smith R, 'Expression of glucocorticoid receptor messenger ribonucleic acid transcripts in the human placenta at term', Journal of Clinical Endocrinology & Metabolism, 93 4887-4893 (2008) [C1]
DOI 10.1210/jc.2008-1077
Citations Scopus - 24Web of Science - 22
Co-authors Vanessa Murphy, Roger Smith
2008 Stark MJ, Clifton VL, Wright IM, 'Sex-specific differences in peripheral microvascular blood flow in preterm infants', Pediatric Research, 63 415-419 (2008) [C1]
DOI 10.1203/01.pdr.0000304937.38669.63
Citations Scopus - 43Web of Science - 40
Co-authors Ian Wright
2008 Osei-Kumah A, Hodyl N, Clifton VL, 'Proteomics in asthma', Expert Review of Clinical Immunology, 4 713-721 (2008)

Proteomic approaches have already been successfully implemented in areas such as cancer research. Surprisingly, only a few proteomics analyses have been published reporting on the... [more]

Proteomic approaches have already been successfully implemented in areas such as cancer research. Surprisingly, only a few proteomics analyses have been published reporting on the protein profiles associated with asthma. Although proteomics has its limitations and experimental challenges, it can successfully contribute to the understanding of a complex disease such as asthma. We have reviewed the current literature that has reported the use of proteomic techniques to identify proteins that may contribute to altered lung function in asthma. Only a few of these studies have used proteomic techniques on human tissues associated with asthma, while most research has been performed with animal models of asthma. Proteomic applications have been used as a complimentary technique to verify the suspected candidate proteins involved in asthma. In addition, novel proteins have been identified as potential therapeutic targets. Future collaboration between the different scientific disciplines using proteomic studies of animal models of asthma and confirmation of these findings in human tissues will significantly contribute to the understanding of the etiology of asthma and lead to the development of new therapeutic strategies for this highly prevalent disease. © 2008 Expert Reviews Ltd.

DOI 10.1586/1744666X.4.6.713
Citations Scopus - 5
2008 Mayhew TM, Jenkins H, Todd B, Clifton VL, 'Maternal asthma and placental morphometry: Effects of severity, treatment and fetal sex', Placenta, 29 366-373 (2008) [C1]
DOI 10.1016/j.placenta.2008.01.011
Citations Scopus - 28Web of Science - 24
2008 Hodyl NA, Krivanek K, Clifton VL, Hodgson DM, 'Innate immune dysfunction in the neonatal rat following prenatal endotoxin exposure', Journal of Neuroimmunology, 204 126-130 (2008) [C1]
DOI 10.1016/j.jneuroim.2008.06.041
Citations Scopus - 17Web of Science - 15
Co-authors Deborah Hodgson
2007 Tolosa Gonzalez JM, Schjenken JE, Civiti TD, Clifton VL, Smith R, 'Column-based method to simultaneously extract DNA, RNA, and proteins from the same sample', Biotechniques, 43 799-804 (2007) [C1]
DOI 10.2144/000112594
Citations Scopus - 27Web of Science - 23
Co-authors Roger Smith
2007 Clifton VL, Bisits AM, Zarzycki PK, 'Characterization of human fetal cord blood steroid profiles in relation to fetal sex and mode of delivery using temperature-dependent inclusion chromatography and principal component analysis (PCA)', Journal of Chromatography B: Analytical Technologies in the Biomedical and Life Sciences, 855 249-254 (2007) [C1]
DOI 10.1016/j.jchromb.2007.05.041
Citations Scopus - 20
2007 Murphy VE, Fittock RJ, Zarzycki PK, Delahunty MM, Smith R, Clifton VL, 'Metabolism of synthetic steroids by the human placenta', Placenta, 28 39-46 (2007) [C1]
DOI 10.1016/j.placenta.2005.12.010
Citations Scopus - 51Web of Science - 41
Co-authors Roger Smith, Vanessa Murphy
2007 Hodyl NA, Krivanek K, Lawrence E, Clifton VL, Hodgson DM, 'Prenatal exposure to a pro-inflammatory stimulus causes delays in the development of the innate immune response to LPS in the offspring', Journal of Neuroimmunology, 190 61-71 (2007) [C1]
DOI 10.1016/j.jneuroim.2007.07.021
Citations Scopus - 31Web of Science - 28
Co-authors Deborah Hodgson
2007 Hodyl NA, Walker FR, Krivanek K, Clifton VL, Hodgson DM, 'Modelling prenatal bacterial infection: Functional consequences of altered hypothalamic pituitary adrenal axis development', Behavioral Brain Research, 178 108-114 (2007) [C1]
DOI 10.1016/j.bbr.2006.12.008
Citations Scopus - 10Web of Science - 9
Co-authors Rohan Walker, Deborah Hodgson
2006 Murphy VE, Clifton VL, Gibson PG, 'Asthma exacerbations during pregnancy: incidence and association with adverse pregnancy outcomes', Thorax, 61 169-176 (2006) [C1]
DOI 10.1136/thx.2005.049718
Citations Scopus - 156Web of Science - 139
Co-authors Peter Gibson, Vanessa Murphy
2006 Osei-Kumah A, Ammit AJ, Smith R, Ge Q, Clifton VL, 'Inflammatory mediator release in normal bronchial smooth muscle cells is altered by pregnant maternal and fetal plasma independent of asthma', Placenta, 27 847-852 (2006) [C1]
DOI 10.1016/j.placenta.2005.08.007
Citations Scopus - 10Web of Science - 9
Co-authors Roger Smith
2006 Murphy VE, Smith R, Giles WB, Clifton VL, 'Endocrine regulation of human fetal growth: The role of the mother, placenta, and fetus', Endocrine Reviews, 27 141-169 (2006) [C1]
DOI 10.1210/er.2005-0011
Citations Scopus - 281Web of Science - 248
Co-authors Roger Smith, Vanessa Murphy
2006 Murphy VE, Johnson RF, Wang YC, Akinsanya K, Gibson PG, Smith R, Clifton VL, 'Proteomic study of plasma proteins in pregnant women with asthma', Respirology, 11 41-48 (2006) [C1]
DOI 10.1111/j.1440-1843.2006.00782.x
Citations Scopus - 20Web of Science - 18
Co-authors Vanessa Murphy, Peter Gibson, Roger Smith
2006 Clifton VL, 'Maternal asthma during pregnancy and fetal outcomes: Potential mechanisms and possible solutions', Current Opinion in Allergy and Clinical Immunology, 6 307-311 (2006) [C2]
Citations Scopus - 14
2006 Zarzycki PK, Kulhanek KM, Smith R, Clifton VL, 'Determination of steroids in human plasma using temperature-dependent inclusion chromatography for metabolomic investigations', Journal of Chromatography A, 1104 203-208 (2006) [C1]
DOI 10.1016/j.chroma.2005.11.119
Citations Scopus - 26Web of Science - 28
Co-authors Roger Smith
2006 Stark MJ, Dierkx LM, Clifton VL, Wright IM, 'Alterations in the Maternal Peripheral Microvascular Response in Pregnancies Complicated by Preeclampsia and the Impact of Fetal Sex', Journal of the Society for Gynecologic Investigation, 13 573-578 (2006) [C1]
DOI 10.1016/j.jsgi.2006.06.006
Citations Scopus - 25Web of Science - 22
Co-authors Ian Wright
2006 Clifton VL, Rennie N, Murphy VE, 'Effect of inhaled glucocorticoid treatment on placental 11 beta-hydroxysteroid dehydrogenase type 2 activity and neonatal birthweight in pregnancies complicated by asthma', Australian and New Zealand Journal of Obstetrics and Gynaecology, 46 136-140 (2006) [C1]
DOI 10.1111/j.1479-828X.2006.00543.x
Citations Scopus - 44Web of Science - 37
Co-authors Vanessa Murphy
2005 Clifton VL, Vanderlelie J, Perkins AV, 'Increased anti-oxidant enzyme activity and biological oxidation in placentae of pregnancies complicated by maternal asthma', Placenta, 26 773-779 (2005) [C1]
DOI 10.1016/j.placenta.2004.10.018
Citations Scopus - 19
2005 Vanderlelie J, Venardos K, Clifton VL, Gude NM, Clarke FM, Perkins AV, 'Increased Biological Oxidation and Reduced Anti-Oxidant Enzyme Activity in Pre-Eclamptic Placentae', Placenta, 26 53-58 (2005) [C1]
DOI 10.1016/j.placenta.2004.04.002
Citations Scopus - 142
2005 Clifton VL, 'Sexually Dimorphic Effects of Maternal Asthma During Pregnancy on Placental Glucocorticoid Metabolism and Fetal Growth', Cell and Tissue Research, 322 63-71 (2005) [C1]
DOI 10.1007/s00441-005-1117-5
Citations Scopus - 51
2005 Murphy VE, Gibson PG, Smith R, Clifton VL, 'Asthma during pregnancy: mechanisms and treatment implications', European Respiratory Journal, 25 731-750 (2005) [C1]
DOI 10.1183/09031936.05.00085704
Citations Scopus - 96Web of Science - 82
Co-authors Roger Smith, Vanessa Murphy, Peter Gibson
2005 Murphy VE, Gibson PG, Talbot PI, Kessell CG, Clifton VL, 'Asthma self-management skills and the use of asthma education during pregnancy', European Respiratory Journal, 26 435-441 (2005) [C1]
DOI 10.1183/09031936.05.00135604
Citations Scopus - 52Web of Science - 42
Co-authors Peter Gibson, Vanessa Murphy
2005 Clifton VL, Crompton R, Read MA, Gibson PG, Smith R, Wright IM, 'Microvascular Effects of Corticotropin-Releasing Hormone in Human Skin Vary in Relation to Estrogen Concentration During the Menstrual Cycle', Journal of Endocrinology, 186 69-76 (2005) [C1]
DOI 10.1677/joe.1.06030
Citations Scopus - 14Web of Science - 11
Co-authors Ian Wright, Roger Smith, Peter Gibson
2005 Murphy VE, Johnson RF, Wang Y-C, Akinsanya K, Gibson PG, Smith R, Clifton VL, 'The Effect of Maternal Asthma on Placental and Cord Blood Protein Profiles', Society for Gynecological Investigation Journal, 12 349-355 (2005) [C1]
DOI 10.1016/j.jsgi.2005.01.024
Citations Scopus - 18Web of Science - 17
Co-authors Vanessa Murphy, Peter Gibson, Roger Smith
2005 Murphy VE, Gibson PG, Talbot PI, Clifton VL, 'Severe asthma exacerbations during pregnancy', Obstetrics and Gynecology, 106 1046-1054 (2005) [C1]
Co-authors Vanessa Murphy, Peter Gibson
2004 Johnson RF, Mitchell CM, Clifton VL, Zakar T, 'Regulation of 15-Hydroxyprostaglandin Dehydrogenase (PGDH) Gene Activity, Messenger Ribonucleic Acid Processing, and Protein Abundance in the Human Chorion in Late Gestation and Labour', The Journal of Clinical Endocrinology and Metabolism, 89 5639-5648 (2004) [C1]
DOI 10.1210/jc.2004-0540
Citations Scopus - 18Web of Science - 17
2004 Clifton VL, Murphy VE, 'Maternal Asthma as a Model for Examining Fetal Sex-specific Effects on Maternal Physiology and Placental Mechanisms that Regulate Human Fetal Growth', Placenta, 18 S45-S52 (2004) [C1]
DOI 10.1016/j.placenta.2004.01.004
Citations Scopus - 84Web of Science - 76
Co-authors Vanessa Murphy
2003 Crompton R, Clifton VL, Bisits AM, Read MA, Smith R, Wright IM, 'Corticotropin-releasing hormone causes vasodilation in human skin via mast cell-dependent pathways', Journal Of Clinical Endocrinology And Metabolism, 88 5427-5432 (2003) [C1]
DOI 10.1210/jc.2003-030377
Citations Scopus - 64Web of Science - 54
Co-authors Ian Wright, Roger Smith
2003 Murphy VE, Clifton VL, 'Alterations in human placental 11 beta-hydroxysteroid dehydrogenase type 1 and 2 with gestational age and labour', Placenta, 24 739-744 (2003) [C1]
DOI 10.1016/S0143-4004(03)00103-6
Citations Scopus - 81Web of Science - 77
Co-authors Vanessa Murphy
2003 Murphy VE, Gibson PG, Giles WB, Zakar T, Smith R, Bisits AM, et al., 'Maternal Asthma Is Associated with Reduced Female Fetal Growth', American Journal of Respiratory & Critical Care Medicine, 168 1317-1323 (2003) [C1]
DOI 10.1164/rccm.200303-374OC
Citations Scopus - 149Web of Science - 140
Co-authors Roger Smith, Vanessa Murphy, Peter Gibson
2003 Smith R, Mesiano S, Clifton V, Chan EC, Zakar T, Nicholson R, et al., 'The pathway to human birth', Cuadernos de Medicina Reproductiva, 9 43-51 (2003)

Preterm labour remains a major obstetric problem with only poor methods for prediction of preterm birth and treatments of preterm labour with limited efficacy. Regulation of human... [more]

Preterm labour remains a major obstetric problem with only poor methods for prediction of preterm birth and treatments of preterm labour with limited efficacy. Regulation of human parturition is demonstrably different from that in most animals restricting opportunities for relevant research. Recent work suggests a placental clock mechanism regulating the length of pregnancy through the production of the placental peptide Corticotrophin Releasing Hormone. At the end of pregnancy most animals initiate labour with a fall in circulating progesterone concentrations but this does not happen in humans. In humans a functional progesterone withdrawal is initiated by a change in myometrial expression of progesterone receptors, specifically increase expression of the PRA isoforms, which is a dominant repressor of the activating receptor PRB. This new knowledge may help design better strategies for prediction and treatment of preterm labour.

Co-authors Roger Smith
2003 Smith R, Mesiano S, Clifton VL, Chan EC, Zakar T, Nicholson RC, et al., 'The Pathway to Human Birth', Cuadernos de Medicina Reproductiva, 9 43-51 (2003) [C1]
Co-authors Roger Smith
2002 Clifton VL, Crompton R, Smith R, Wright ML, 'Microvascular Effects of CRH in Human Skin Vary in Relation to Gender', The Journal of Clinical Endocrinology & Metabolism, 87(1) 267-270 (2002) [C1]
DOI 10.1210/jc.87.1.267
Citations Scopus - 28Web of Science - 25
Co-authors Ian Wright, Roger Smith
2002 Murphy VE, Zakar T, Smith R, Giles WB, Gibson PG, Clifton VL, 'Reduced 11 -Hydroxysteroid Dehydrogenase Type 2 Activity Is Associated with Decreased Birth Weight Centile in Pregnancies Complicated by Asthma', The Journal of Clinical Endocrinology & Metabolism, 87(4) 1660-1668 (2002) [C1]
Citations Scopus - 101Web of Science - 96
Co-authors Peter Gibson, Vanessa Murphy, Roger Smith
2002 Clifton VL, Wallace EM, Smith R, 'Short-term effects of glucocorticoids in the human fetal-placental circulation in vitro', Journal of Clinical Endocrinology and Metabolism, 87 2838-2842 (2002) [C1]
Citations Scopus - 29Web of Science - 28
Co-authors Roger Smith
2002 Holloway AC, Howe DC, Chan G, Clifton VL, Smith R, Challis JRG, 'Urocortin: A mechanism for the sustained activation of the HPA axis in the late-gestation ovine fetus?', American Journal of Physiology - Endocrinology and Metabolism, 283 (2002)

We hypothesized that urocortin might be produced in the pituitary of the late-gestation ovine fetus in a manner that could contribute to the regulation of ACTH output. We used in ... [more]

We hypothesized that urocortin might be produced in the pituitary of the late-gestation ovine fetus in a manner that could contribute to the regulation of ACTH output. We used in situ hybridization and immunohistochemistry to identify urocortin mRNA and protein in late-gestation fetal pituitary tissue. Levels of urocortin mRNA rose during late gestation and were associated temporally with rising concentrations of pituitary proopiomelanocortin (POMC) mRNA. Urocortin was localized both to cells expressing ACTH and to non-ACTH cells by use of dual immunofluorescence histochemistry. Transfection of pituitary cultures with urocortin antisense probe reduced ACTH output, whereas added urocortin stimulated ACTH output from cultured pituitary cells. Cortisol infusion for 96 h in chronically catheterized late-gestation fetal sheep significantly stimulated levels of pituitary urocortin mRNA. We conclude that urocortin is expressed in the ovine fetal pituitary and localizes with, and can stimulate output of, ACTH. Regulation of urocortin by cortisol suggests a mechanism to override negative feedback and sustain feed-forward of fetal hypothalamic-pituitary-adrenal function, leading to birth.

Citations Scopus - 11
Co-authors Roger Smith
2002 O'Dwyer DT, Clifton VL, Hall AL, Smith R, Robinson P, Crock PA, 'Pituitary Autoantibodies in Lymphocytic Hypophysitis Target Both - and - Enolase - A Link with Pregnancy?', Archives of Physiology and Biochemistry, 110(1-2) 94-98 (2002) [C1]
Citations Scopus - 54
Co-authors Roger Smith
2002 Schwartz J, Revskoy S, Redei E, Clifton VL, Smith R, Cherny R, 'Corticotrophs and peptides', Archives of Physiology and Biochemistry, 110 146-153 (2002) [C1]
Citations Scopus - 3
Co-authors Roger Smith
2002 Holloway AC, Howe DC, Chan G, Clifton VL, Smith R, Challis RG, 'Urocortin: A mechanism for the sustained activation of the HPA axis in the late gestation ovine fetus?', American Journal of Physiology ¿ Endocrinology and Metabolism, 283 165-171 (2002) [C1]
Citations Web of Science - 10
Co-authors Roger Smith
2001 Clifton VL, Gu Q, Murphy VE, Schwartz J, Madsen G, Smith R, 'Erratum: Localization and characterization of urocortin during human pregnancy (Placenta (2000) vol. 21 (782-788))', Placenta, 22 264 (2001)
DOI 10.1053/plac.2001.0632
Co-authors Roger Smith, Vanessa Murphy
2001 Gu Q, Clifton VL, Schwartz J, Madsen G, Sha JY, Smith R, 'Characterization of urocortin in human pregnancy', CHINESE MEDICAL JOURNAL, 114 618-622 (2001)
Citations Scopus - 7Web of Science - 7
Co-authors Roger Smith
2001 Clifton VL, Giles WB, Smith R, Bisits AM, Hempenstall P, Kessell C, Gibson PG, 'Alterations of Placental Vascular Function in Asthmatic Pregnancies', American Journal of Respiratory and Critical Care Medicine, 164 546-553 (2001) [C1]
Citations Scopus - 47Web of Science - 39
Co-authors Roger Smith, Peter Gibson
2000 McLean M, Bowman M, Clifton VL, Smith R, Grossman AB, 'Expression of the Heme Oxygenase-Carbon Monoxide Signalling system in Human Placenta', The Journal of Clinical Endocrinology & Metabolism, 85 2345-2349 (2000) [C1]
Citations Scopus - 44Web of Science - 38
Co-authors Roger Smith, Maria Bowman
2000 Clifton VL, Qing G, Murphy VE, Schwartz J, Madsen GM, Smith R, 'Localization and Characterization of Urocortin during Human Pregancy', Placenta, 21 782-788 (2000) [C1]
Citations Scopus - 44Web of Science - 39
Co-authors Vanessa Murphy, Roger Smith
1999 Patel FA, Clifton VL, Chwalisz K, Challis JRG, 'Steroid regulation of prostaglandin dehydrogenase activity and expression in human term placenta and chorio-decidua in relation to labor', Journal of Clinical Endocrinology and Metabolism, 84 291-299 (1999)

NAD + -dependent 15-hydroxyprostaglandin dehydrogenase (PGDH) is the key catabolic enzyme controlling levels of biologically active PGs. PGDH is localized to syncytiotrophoblast i... [more]

NAD + -dependent 15-hydroxyprostaglandin dehydrogenase (PGDH) is the key catabolic enzyme controlling levels of biologically active PGs. PGDH is localized to syncytiotrophoblast in placenta, and to trophoblast cells in chorion. To examine the regulation of PGDH by steroids and to determine any changes with labor, we obtained placenta and chorion from term elective cesarean section or spontaneous delivery and isolated trophoblast cells using a Percoll density gradient. Cells were treated with varying concentrations of cortisol, progesterone, the synthetic progestins R5020, and medroxyprogesterone acetate with or without RU486 or the specific progesterone receptor antagonist, onapristone, and the 3ß-hydroxysteroid dehydrogenase inhibitor, trilostane. The activity of PGDH was assessed by measurement of 13,14-dihydro-15-keto-PGF(2a). PGDH messenger ribonucleic acid was quantified by in situ hybridization and computerized image analysis. The basal output of 13,14-dihydro-15-keto-PGF(2a) was lower in placenta or chorion collected at spontaneous labor than in that obtained at elective cesarean section. Cortisol had a significant dose-dependent inhibitory effect on PGDH activity in both placental and chorion trophoblast cells and significantly decreased levels of PGDH messenger ribonucleic acid. Responses were similar between tissues from laboring and nonlaboring women. PGDH activity was increased by R5020 and medroxyprogesterone acetate and was inhibited by RU486, onapristone, and trilostane. We conclude that cortisol inhibits PGDH activity and expression and that progestagens increase PGDH activity in human chorion and placenta.

DOI 10.1210/jc.84.1.291
Citations Scopus - 82
1998 Clifton VL, Telfer JF, Thompson AJ, Cameron IT, Teoh TG, Lye SJ, Challis JRG, 'Corticotropin-releasing hormone and proopiomelanocortin-derived peptides are present in human myometrium', Journal of Clinical Endocrinology and Metabolism, 83 3716-3721 (1998)

CRH and POMC-derived peptides are produced at a number of intrauterine sites in both the nonpregnant and pregnant states. It is hypothesized that CRH and POMC-derived peptides may... [more]

CRH and POMC-derived peptides are produced at a number of intrauterine sites in both the nonpregnant and pregnant states. It is hypothesized that CRH and POMC-derived peptides may be produced locally by the uterus to modulate myometrial contractility. This study has examined the distribution of these peptides in human uterine tissue during the ovulatory cycle and pregnancy. The immunoperoxidase staining method was used to localize CRH and POMC-derived peptides: ACTH, ß-endorphin, and aMSH. Immunoreactive (IR-) CRH and IR-POMC-derived peptides, ß-endorphin and aMSH, were observed in the myometrial smooth muscle, vascular smooth muscle, endometrial glandular epithelium, and luminal epithelium of the nonpregnant uterus (n = 17). Staining for IR-CRH did not change during the cycle from the proliferative (n = 8) to the secretory phases (n = 9). Conversely, staining for IR-ß- endorphin and IR-aMSH was only observed during the secretory phase of the cycle (n = 9). In uterine tissue obtained from pregnant women (n = 20) IR- CRH was present in the myometrial smooth muscle, vascular smooth muscle, decidua, and glandular epithelium. IR-POMC-derived peptides were not detectable at any uterine site during pregnancy (n = 20). IR-CRH was measurable in myometrial extracts collected from pregnant women undergoing cesarean section (20.9 ± 3.8 ng/g wet wt; n = 7) and from nonpregnant premenopausal women undergoing hysterectomy (7.7 ± 2.1 ng/g wet wt; n = 6). IR-CRH concentrations significantly increased with pregnancy. Levels of messenger ribonucleic acid encoding for CRH were examined in nonpregnant (n = 4) and pregnant (n = 10) myometrial smooth muscle and were also significantly increased with pregnancy. This study has demonstrated that levels of CRH and POMC peptide in human uterine tissue change with pregnancy and that CRH is produced locally by myometrial smooth muscle cells. These studies are consistent with the possibility that the CRH peptide has an autocrine/paracrine activity during pregnancy and labor that may be related to the modulation of myometrial contractility.

DOI 10.1210/jc.83.10.3716
Citations Scopus - 49
1997 Clifton VL, Challis JRG, 'Placental corticotropin releasing hormone function during human pregnancy', Endocrinologist, 7 448-458 (1997)

Corticotropin releasing hormone (CRH) is produced in intrauterine sites including the placenta, decidua, and myometrium during human pregnancy. Placental CRH may have endocrine, p... [more]

Corticotropin releasing hormone (CRH) is produced in intrauterine sites including the placenta, decidua, and myometrium during human pregnancy. Placental CRH may have endocrine, paracrine, and autocrine functions. Its output into the maternal circulation increases as a function of gestation and correlates with increases in levels of mRNA encoding CRH in placental syncytiotrophoblast. Regulation of placental CRH expression and activity is multifactorial, being inhibited by progesterone and nitric oxide (NO), and stimulated by cytokines, neuropeptides, and glucocorticoids. CRH acts as a vasodilator in perfused placental tissue in vitro, may modulate maternal and fetal pituitary function, and has been implicated in mechanisms associated with the onset of labor at term and preterm.

Citations Scopus - 7
1996 Clifton VL, Read MA, Boura ALA, Robinson PJ, Smith R, 'Adrenocorticotropin causes vasodilatation in the human fetal-placental circulation', JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 81 1406-1410 (1996)
DOI 10.1210/jc.81.4.1406
Citations Scopus - 22Web of Science - 20
Co-authors Roger Smith
1995 CLIFTON VL, OWENS PC, ROBINSON PJ, SMITH R, 'IDENTIFICATION AND CHARACTERIZATION OF A CORTICOTROPIN-RELEASING HORMONE-RECEPTOR IN HUMAN PLACENTA', EUROPEAN JOURNAL OF ENDOCRINOLOGY, 133 591-597 (1995)
Citations Scopus - 35Web of Science - 34
Co-authors Roger Smith
1995 CLIFTON VL, READ MA, LEITCH IM, GILES WB, BOURA ALA, ROBINSON PJ, SMITH R, 'CORTICOTROPIN-RELEASING HORMONE-INDUCED VASODILATATION IN THE HUMAN FETAL-PLACENTAL CIRCULATION - INVOLVEMENT OF THE NITRIC OXIDE CYCLIC GUANOSINE 3',5'-MONOPHOSPHATE-MEDIATED PATHWAY', JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 80 2888-2893 (1995)
DOI 10.1210/jc.80.10.2888
Citations Scopus - 130Web of Science - 115
Co-authors Roger Smith
1994 CLIFTON VL, READ MA, LEITCH IM, BOURA ALA, ROBINSON PJ, SMITH R, 'CORTICOTROPIN-RELEASING HORMONE-INDUCED VASODILATATION IN THE HUMAN FETAL-PLACENTAL CIRCULATION', JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 79 666-669 (1994)
DOI 10.1210/jc.79.2.666
Citations Scopus - 97Web of Science - 93
Co-authors Roger Smith
1993 Kay DJ, Clifton V, Taylor JS, Boettcher B, 'Anti-sperm antibodies and semen profiles in re-anastomosed men', Reproduction, Fertility and Development, 5 135-139 (1993)

A group of 29 re-anastomosed men were examined with respect to semen quality, anti-sperm antibody titres in serum and seminal plasma, presence of anti-sperm antibodies on sperm, a... [more]

A group of 29 re-anastomosed men were examined with respect to semen quality, anti-sperm antibody titres in serum and seminal plasma, presence of anti-sperm antibodies on sperm, and success rate in inducing pregnancy. Results indicated no association between pre-reversal serum anti-sperm antibody titres and post-reversal semen quality, but a pregnancy induction rate of zero was associated with serum anti-sperm antibody titres greater than 160. It is recommended that men considering reversal, with anti-sperm antibody titres of this level, should receive counselling about the possibility of postreversal infertility. © 1993 CSIRO. All rights reserved.

DOI 10.1071/RD9930135
Citations Scopus - 16
1992 CLIFTON VL, HUSBAND AJ, KAY DJ, 'LOCAL IMMUNITY IN THE MALE REPRODUCTIVE-TRACT', IMMUNOLOGY AND CELL BIOLOGY, 70 301-307 (1992)
DOI 10.1038/icb.1992.38
Citations Web of Science - 9
1992 CLIFTON VL, HUSBAND AJ, KAY DJ, 'Local immunity in the male reproductive tract', Immunology and Cell Biology, 70 301-307 (1992)

In previous studies we have demonstrated that the male urinary tract forms part of the common mucosal immune system, and that the gut contributes to local defences at this site. 1... [more]

In previous studies we have demonstrated that the male urinary tract forms part of the common mucosal immune system, and that the gut contributes to local defences at this site. 1 The question arises as to the extent to which the reproductive tract also forms part of the common mucosal immune system. Rats were immunized by a variety of routes designed to stimulate a local response in the intestine and/or the reproductive tract. Rats immunized only by the intratesticular (i.t.) route yielded no antibody-containing (ACC) response in any of the tissues examined. Intestinal immunization using intraperitoneal priming followed by intraduodenal challenge (i.p./i.d.) yielded a substantial IgA-specific ACC response in the jejunum, but no ACC were detectable in any of the reproductive tract tissues. However, when intestinal and testicular immunizations were combined, large numbers of IgA-specific antibodies were detected in all tissues examined. Chronic drainage of the thoracic lymphatic duct throughout the post-challenge period abrogated the ACC response in all tissues of the reproductive tract, indicating that the ACC appearing at these sites after immunization were of gut origin. The IgA-specific anti-OVA antibody detectable in serum, saliva and testis homogenate reflected the ACC counts in histological sections. The studies reported here confirm that the male reproductive tract does form part of a common mucosal immune system and that gut-associated lymphoid tissues may contribute cellular precursors for ACC, particularly those of IgA specificity, appearing in the tract after local challenge. The implications of these findings to infectious disease involving the urogenital tract are obvious and investigation of oral vaccines to control sexually transmitted disease as well as acquired urinary tract infections deserves further attention. There are further implications, however, for the understanding and management of male infertility. Copyright © 1992, Wiley Blackwell. All rights reserved

DOI 10.1111/j.1440-1711.1992.tb03730.x
Citations Scopus - 10
1989 HUSBAND AJ, CLIFTON VL, 'ROLE OF INTESTINAL IMMUNIZATION IN URINARY-TRACT DEFENSE', IMMUNOLOGY AND CELL BIOLOGY, 67 371-376 (1989)
DOI 10.1038/icb.1989.53
Citations Scopus - 11Web of Science - 11
Show 152 more journal articles

Conference (94 outputs)

Year Citation Altmetrics Link
2012 Aboustate N, Stark MJ, Clifton VL, Hodyl NA, 'Toll-Like Receptor activation in preterm neonates: The effect of gestational age and antenatal betamethasone therapy', Abstracts. The Annual Scientific Meeting of the Endocrine Society of Australia and the Society for Reproductive Biology 2012 (2012) [E3]
2012 Ali Z, Hodyl NA, Osei-Kumah A, Saif Z, Clifton VL, 'Placental mitochondrial dysfunction in pregnancies complicated by asthma', Abstracts. The Annual Scientific Meeting of the Endocrine Society of Australia and the Society for Reproductive Biology 2012 (2012) [E3]
2012 Clifton VL, Hodyl NA, Stark MJ, Saif Z, Osei-Kumah A, 'Sex specific differences in placental glucocorticoid sensitivity in pathological pregnancies', Abstracts. The Annual Scientific Meeting of the Endocrine Society of Australia and the Society for Reproductive Biology 2012 (2012) [E3]
2012 Hodyl NA, Butler M, Clifton VL, Stark MJ, 'Mitochondrial uncoupling protein 2 in the placenta may protect the preterm infant from increased reactive oxygen species following chorioamnionitis', Abstracts. The Annual Scientific Meeting of the Endocrine Society of Australia and the Society for Reproductive Biology 2012 (2012) [E3]
2012 Osei-Kumah A, Saif Z, Hodyl NA, Stark MJ, Clifton VL, 'Effect of cortisol and lipopolysaccharide on micro RNA and glucocorticoid receptor expression', Abstracts. The Annual Scientific Meeting of the Endocrine Society of Australia and the Society for Reproductive Biology 2012 (2012) [E3]
2012 Powell HG, McCaffery K, Murphy VE, Giles W, Clifton VL, Hensley MJ, Gibson PG, 'Psychosocial outcomes are related to future exacerbation risk and perinatal outcomes in pregnant women with asthma', Respirology (2012) [E3]
Citations Web of Science - 1
Co-authors Peter Gibson, Vanessa Murphy, Michael Hensley
2012 Wright IM, Latter JL, Wright A, Finnegan T, Clifton VL, 'Maternal peripheral constriction in preeclampsia is not reflected in the central microvasculature', Journal of Paediatrics and Child Health (2012) [E3]
Co-authors Joanna Latter, Ian Wright
2012 Wright IM, Latter JL, Wright A, Finnegan T, Clifton VL, 'Functional capillary density in babies born to mothers with preeclampsia', 16th Annual Congress of the Perinatal Society of Australia and New Zealand (2012) [E3]
Co-authors Joanna Latter, Ian Wright
2012 Clifton VL, Stark MJ, Osei-Kumah A, Hodyl NA, 'Review: The feto-placental unit, pregnancy pathology and impact on long term maternal health', Placenta (2012)

Pregnancy induces a number of alterations to maternal physiology to accommodate the increased demands made by the developing fetus and placenta. These alterations appear at least ... [more]

Pregnancy induces a number of alterations to maternal physiology to accommodate the increased demands made by the developing fetus and placenta. These alterations appear at least in part to be driven by products derived from the feto-placental unit, including microchimeric cells, as well as placental exosomes and microparticles, inducing changes to maternal physiology both during pregnancy and beyond. Further, increasing evidence suggests that some of these alterations are dependent on the sex of the fetus. Pre-eclampsia and asthma represent two common pregnancy complications that have provided valuable insight into how the feto-placental unit influences maternal physiology in a sex-specific manner. Pregnancy-induced alterations in maternal physiology may expose pre-existing subclinical pathologies and provide insight into future maternal health and disease. While most pregnancy-induced alterations to the maternal system are reversed following delivery, some can persist after parturition leading to cardiovascular, metabolic and autoimmune disease and increased risk of early mortality. © 2012 Published by IFPA and Elsevier Ltd.

DOI 10.1016/j.placenta.2011.11.005
Citations Scopus - 28
2011 Wright IM, Dyson RM, Latter JL, Clifton VL, 'Microvascular blood flow changes from 6 to 24 h in the preterm infant', Journal of Paediatrics and Child Health (2011) [E3]
Co-authors Joanna Latter, Ian Wright
2010 Hodyl NA, Smith R, Bisits AM, Gibson PG, Clifton VL, 'The effect of inhaled corticosteroids on maternal and fetal systemic function and placental activity in women with asthma', Reproductive Sciences (2010) [E3]
DOI 10.1177/193371912010173s003
Co-authors Peter Gibson, Roger Smith
2010 Osei-Kumah A, Hodyl N, Owens J, Clifton VL, 'Sex specific differences in placental micro RNA expression in pregnancies complicated by asthma', Reproductive Sciences (2010) [E3]
2010 McLernon PC, Murphy VE, Wood LG, Dekker GA, Hodyl NA, Clifton VL, 'Maternal plasma circulating levels of omega (n)3 long chain polyunsaturated fatty acids, eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA) are associated with fetal growth measures', The Endocrine Society of Australia Annual Scientific Meeting Proceedings and Abstract Book (2010) [E3]
Co-authors Lisa Wood, Vanessa Murphy
2010 Fogarty PA, Hetzel BS, Nettelback TJ, Roberts R, Hodyl NA, Torpy DJ, et al., 'Mandatory iodine fortification of bread in Australia: iodine status of pregnant women', The Endocrine Society of Australia Annual Scientific Meeting Proceedings and Abstract Book (2010) [E3]
2010 Tolosa Gonzalez JM, Schjenken JE, Clifton VL, Smith R, 'A new function for the fusogenic endogenous retroviral envelope protein syncytin-1: assessment of its immunosuppressive properties', The Endocrine Society of Australia Annual Scientific Meeting Proceedings and Abstract Book (2010) [E3]
Co-authors Roger Smith
2010 McLernon PC, Wood LG, Murphy VE, Dekker GA, Clifton VL, 'Maternal circulating levels of omega (N)3 long chain polyunsaturated fatty acids, eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA) and docosahexaunoic acid (DHA) during early pregnancy are associated with detal growth meaures in later pregnancy', Placenta (2010) [E3]
Co-authors Lisa Wood, Vanessa Murphy
2010 Tolosa Gonzalez JM, Schjenken JE, Clifton VL, Smith R, 'The retroviral envelope protein syncytin-1 is immunosuppressive and has hijacked the exosomal pathway in the human placenta', Placenta (2010) [E3]
Citations Web of Science - 1
Co-authors Roger Smith
2010 Schjenken JE, Tolosa Gonzalez JM, Clifton VL, Smith R, 'The endogenous retroviral envelope protein syncytin-1 inhibits the release of TNF alpha and IFN gamma in human blood cells', Journal of Reproductive Immunology (2010) [E3]
Co-authors Roger Smith
2010 Stark MJ, Hodyl NA, Scott NM, Osei-Kumah A, Clifton VL, 'The mediating effects of testosterone, progesterone and estradiol on placental cytokin production', Journal of Paediatrics and Child Health: Abstracts of the 14th Annual Congress of the Perinatal Society of Australia and New Zealand 2010 (2010) [E3]
2010 Wright IM, Latter JL, Finnegan T, Clifton VL, 'Placental vascular mediators in preeclampsia', Journal of Paediatrics and Child Health: Abstracts of the 14th Annual Congress of the Perinatal Society of Australia and New Zealand 2010 (2010) [E3]
Co-authors Ian Wright, Joanna Latter
2010 Hodyl NA, Stark MJ, Osei-Kumah A, Bowman M, Clifton VL, 'The effect of inhaled corticosteroid treatment for asthma during pregnancy on markers of maternal, placental and fetal systemic function', Journal of Paediatrics and Child Health: Abstracts of the 14th Annual Congress of the Perinatal Society of Australia and New Zealand 2010 (2010) [E3]
Co-authors Maria Bowman
2010 McLaughlin KM, Steel KR, McCaffery K, Powell HG, Clifton VL, Giles W, et al., 'Psychosocial characteristics and perceived medication risk in pregnant women and asthma', Journal of Paediatrics and Child Health: Abstracts of the 14th Annual Congress of the Perinatal Society of Australia and New Zealand 2010 (2010) [E3]
Co-authors Michael Hensley, Peter Gibson
2009 Schjenken JE, Tolosa Gonzalez JM, Clifton VL, Smith R, 'Corticotrophin releasing hormone modulates the production of immunosuppressive factors FasL, Syncytin and Exosomes by the human placenta', Reproductive Sciences (2009) [E3]
Co-authors Roger Smith
2009 Wright IM, Smith AJ, Clifton VL, Stark MJ, 'Nappy urine collection for physiological measures: A current method', Journal of Paediatrics and Child Health (2009) [E3]
DOI 10.1111/j.1440-1754.2009.01475.x
Co-authors Anthony Smith, Ian Wright
2008 Wynne OL, Horvat JC, Smith R, Hansbro PM, Clifton VL, Hodgson DM, 'Impact of neonatal infection on adult hippocampal glucocorticoid receptor, mineralocorticoid receptor and corticotrophin releasing hormone mRNA abundance', Proceedings of the Australian Neuroscience Society (2008) [E3]
Co-authors Philip Hansbro, Jay Horvat, Roger Smith, Olivia Wynne, Deborah Hodgson
2008 Wright IM, Clifton VL, 'Microvascular orthogonal polarisation spectral imaging videomicroscopy (OPS) in mother and newborn using a handheld microscope: Technical pitfalls and solutions', Journal of Paediatrics and Child Health (2008) [E3]
DOI 10.1111/j.1440-1754.2008.01299.x
Co-authors Ian Wright
2008 Stark MJ, Clifton VL, Wright IM, 'The influence of sex and antenatal glucocorticoid exposure on microvascular vasodilatory capacity in the preterm infant', Journal of Paediatrics and Child Health (2008) [E3]
DOI 10.1111/j.1440-1754.2008.01299.x
Co-authors Ian Wright
2008 Stark MJ, Clifton VL, Wright IM, 'Predictors of microvascular blood flow in very preterm infants at 24 hours of age', Journal of Paediatrics and Child Health (2008) [E3]
DOI 10.1111/j.1440-1754.2008.01297.x
Co-authors Ian Wright
2008 Murphy VE, Clifton VL, Gibson PG, 'Characterization of asthma control and airway inflammation during exacerbations in pregnancy', American Journal of Respiratory and Critical Care Medicine (2008) [E3]
Co-authors Peter Gibson, Vanessa Murphy
2008 Wynne OL, Horvat JC, Smith R, Hansbro PM, Clifton VL, Hodgson DM, 'Impact of neonatal infection on adult hippocampal glucocorticoid receptor and mineralocorticoid receptor abundance', 15th Annual Meeting of the Psychoneuroimmunology Research Society: Program (2008) [E3]
Co-authors Deborah Hodgson, Jay Horvat, Olivia Wynne, Roger Smith, Philip Hansbro
2008 Osei-Kumah A, Wark PA, Smith R, Ammit A, Clifton VL, 'A model of pregnancy induced changes in asthma', 51st Annual Scientific Meeting of the Endocrine Society of Australia and Society of Reproductive Biology: Meeting Proceedings and Abstract Book (2008) [E3]
Co-authors Roger Smith, Peter Wark
2008 Hodyl N, Wyper H, Scott NM, Osei-Kumah A, Murphy VE, Smith R, Clifton VL, 'Relationship between placental glucocorticoid receptor expression and fetal growth in pregnancies complicated by asthma', 51st Annual Scientific Meeting of the Endocrine Society of Australia and Society of Reproductive Biology: Meeting Proceedings and Abstract Book (2008) [E3]
Co-authors Vanessa Murphy, Roger Smith
2008 Burgess R, Clifton VL, 'Micro-chimerism: Mother and child', ArtsHealth Symposium #1. Program and Abstracts (2008) [E3]
2008 Stark MJ, Wright IM, Clifton VL, 'Antenatal betamethasone exerts sexually dimorphic effects on placental glucocorticoid metabolism and fetal and neonatal adrenal function following preterm birth', Archives of Disease in Childhood: Fetal and Neonatal Edition (2008) [E3]
Co-authors Ian Wright
2008 Stark MJ, Clifton VL, Wright IM, 'Sex-specific differences in circulating carbon monoxide and the increased incidence of hypotension in male preterm infants', Archives of Disease in Childhood: Fetal and Neonatal Edition (2008) [E3]
Co-authors Ian Wright
2007 Tolosa Gonzalez JM, Schjenken JE, Scott NM, Clifton VL, Smith R, 'Immunosuppressive properties of a synthetic peptide analogous to human syncytin immunosuppressive peptide', Endocrine Journal (2007) [E3]
Co-authors Roger Smith
2007 Hodyl NA, Stark MJ, Clifton VL, Wright IM, 'Pre-eclampsia affects incidence of infants born small for gestational age differentially depending on both infant sex and degree of prematurity', Endocrine Journal (2007) [E3]
Co-authors Ian Wright
2007 Schjenken JE, Tolosa Gonzalez JM, Clifton VL, Smith R, 'Potential role of CRH in mediating immune function in pregnancy', Endocrine Journal (2007) [E3]
Co-authors Roger Smith
2007 Hodyl NA, Krivanek K, Clifton VL, Hodgson DM, 'A developmental profile of the capacity of the innate immune system to respond to LPS following prenatal endotoxin exposure in the rat', Endocrine Journal (2007) [E3]
Co-authors Deborah Hodgson
2007 Stark MJ, Clifton VL, Wright IM, 'Sex specific differences peripheral microvascular blood flow are a marker of clinical illness severity in the preterm infant', Journal of Paediatrics and Child Health (2007) [E3]
Co-authors Ian Wright
2007 Scott NM, Stark MJ, Wright IM, Hodgson DM, Smith R, Clifton VL, 'Placental inflammatory response in pregnancies complicated by preterm delivery or asthma', Journal of Paediatrics and Child Health (2007) [E3]
Co-authors Roger Smith, Deborah Hodgson, Ian Wright
2007 Stark MJ, Clifton VL, Wright IM, 'Sexually dimorphic differences in microvascular function influence physiological stability following premature birth', Microcirculation (2007) [E3]
Co-authors Ian Wright
2007 Zamudio S, Stark MJ, Illsley N, Torricos T, Alvarez T, Vargas E, Clifton VL, 'Elevation of placental 11bHSD2 activity at high altitude and fetal sex specific decreases in preeclampsia', Reproductive Sciences (Scientific Program & Abstracts: 54th Annual Meeting, SGI) (2007) [E3]
2007 Tolosa Gonzalez JM, Schjenken JE, Clifton VL, Smith R, 'Evidence for syncytin expression in human placental exosomes', Reproductive Sciences (Scientific Program & Abstracts: 54th Annual Meeting, SGI) (2007) [E3]
Co-authors Roger Smith
2007 Wynne OL, Horvat JC, Smith R, Hansbro PM, Clifton VL, Hodgson DM, 'Impact of neonatal infection on adult hippocampal corticosterone receptor abundance and circulating corticosterone', Early Human Development (2007) [E3]
Co-authors Olivia Wynne, Roger Smith, Philip Hansbro, Deborah Hodgson, Jay Horvat
2007 Stark MJ, Hodyl NA, Wright IM, Clifton VL, 'Determinants of fetal growth following assisted conception: Effects of early onset pre-eclampsia', Early Human Development (2007) [E3]
Co-authors Ian Wright
2007 Schjenken JE, Tolosa Gonzalez JM, Civiti TD, Clifton VL, Smith R, 'An improved method to simultaneously extract DNA, RNA and protein from the same sample', Endocrine Journal (2007) [E3]
Co-authors Roger Smith
2007 Stark MJ, Wright IM, Clifton VL, 'Placental 11b hydroxysteroid dehydrogenase 2 and regulation of fetal adrenal function: The influence of exogenouse gluco-corticoids and fetal sex in normal and growth restricted infants', Fetal & Neonatal Workshop of Australia and New Zealand 21st Annual Meeting. Abstracts (2007) [E3]
Co-authors Ian Wright
2007 Wynne OL, Horvat JC, Hansbro PM, Clifton VL, Hodgson DM, 'Impact of postnatal stress on neuroendocrine development and function in adulthood in the mouse', Fetal & Neonatal Workshop of Australia and New Zealand 21st Annual Meeting. Abstracts (2007) [E3]
Co-authors Deborah Hodgson, Olivia Wynne, Jay Horvat, Philip Hansbro
2007 Stark MJ, Wright IM, Clifton VL, 'Placental 11b-hydroxysteroid dehydrogenase 2 activity in preterm pregnancy after antenatal betamethasone treatment', Journal of Paediatrics and Child Health (2007) [E3]
Co-authors Ian Wright
2007 Scott NM, Stark MJ, Wright IM, Hodgson DM, Smith R, Clifton VL, 'Response of placental explants from term and preterm pregnancies to an immune challenge', Reproductive Sciences (Scientific Program & Abstracts: 54th Annual Meeting, SGI) (2007) [E3]
Co-authors Roger Smith, Deborah Hodgson, Ian Wright
2007 Murphy VE, Clifton VL, Gibson PG, 'Fractional exhaled nitric oxide (FENO) in pregnant women with and without asthma', Respirology (TSANZ Abstracts-Posters) (2007) [E3]
Co-authors Vanessa Murphy, Peter Gibson
2007 Talbot PI, Wright IM, Hilton JM, Mattes J, Clifton VL, 'Effect of maternal asthma during pregnancy on childhood growth and development of atopic disease', Respirology (TSANZ Abstracts-Posters) (2007) [E3]
Co-authors Ian Wright, Joerg Mattes
2007 Stark MJ, Wright IM, Clifton VL, 'Temporal changes in mediators of microvascular tone are influences by sex and glucocorticoid exposure in preterm infants', Satellite Conference of DOHaD 2007 (5th World Congress of Developmental Origins of Health and Disease) (2007) [E3]
Co-authors Ian Wright
2007 Clifton VL, Jenkins H, Parrott EH, Stanley S, Todd B, Mayhew TM, 'Maternal asthma, whether grouped by glucocorticoid status or severity, is associated with impoverished fetoplacental vascular growth', Placenta (2007) [E3]
2007 Clifton VL, Mayhew TM, Wright IM, Stark MJ, Giles WB, 'The effects of pre-eclampsia, asthma and fetal sex on maternal, fetal and neonatal characteristics', Placenta (2007) [E3]
Co-authors Ian Wright
2006 Stark MJ, Clifton VL, Wright IM, 'Neonates born to mothers with pre-eclampsia (PE) exhibit altered microvascular function', European Journal of Pediatrics (2006) [E3]
Co-authors Ian Wright
2006 Scott NM, Stark MJ, Wright IM, Hodgson DM, Smith R, Clifton VL, 'Differences in tumour mecrosis factor alpha production by term and preterm placentae', Endocrine Journal-Continuation of Endocrinologia Japonica (2006) [E3]
Co-authors Ian Wright, Roger Smith, Deborah Hodgson
2006 Clifton VL, Osei-Kumah A, Soleymanlou N, Jurisica I, Caniggia I, 'Placental gene expression is altered by fetal sex, maternal asthma and inhaled glucocorticoid intake', Endocrine Journal-Continuation of Endocrinologia Japonica (2006) [E3]
2006 Stark MJ, Wright IM, Clifton VL, 'The impact of antenatal corticosteroids on umbilical venous and arterial cortisol in neonates 23-41 weeks gestation', Endocrine Journal-Continuation of Endocrinologia Japonica (2006) [E3]
Co-authors Ian Wright
2006 Micallef MA, Garg ML, Wood LG, Murphy VE, Clifton VL, 'Dietry intake of long chain n-3 polyunsaturated fatty acids in adults with asthma', Asia Pacific Journal of Clinical Nutrition (2006) [E3]
Co-authors Vanessa Murphy, Lisa Wood, Manohar Garg
2006 Wright IMR, Clifton VL, Stark MJ, 'Characterisation of microvascular function in very preterm infants in the first week of life', JOURNAL OF VASCULAR RESEARCH (2006)
Co-authors Ian Wright
2006 Clifton VL, Wyper H, Smith R, Johnson RF, Osei-Kumah A, 'Placental glucocorticoid receptor expression in pregnancies complicated by asthma (poster presentation)', Journal of the Society for Gynecologic Investigation (Vol. 13, no. 2: 667) Scientific Program and Abstracts 53rd Annual Meeting (2006) [E3]
Co-authors Roger Smith
2006 Clifton VL, Wyper H, Scott N, Osei-Kumah A, 'Identification and characterisation of macrophages in placentae from pregnancies complicated by asthma (Poster presentation)', Journal of the Society for Gynecologic Investigation (Vol. 13, no. 2: 667) Scientific Program and Abstracts 53rd Annual Meeting (2006) [E3]
2006 Osei-Kumah A, Ammit A, Smith R, Clifton VL, 'Maternal and cord plasma cytokine profiles in pregnancies complicated by asthma (Poster presentation)', Journal of the Society for Gynecologic Investigation (Vol. 13, no. 2: 667) Scientific Program and Abstracts 53rd Annual Meeting (2006) [E3]
Co-authors Roger Smith
2006 Stark MJ, Wright IM, Clifton VL, 'Maternal microvascular response to corticotrophin releasing hormone (CRH) is altered by gestation, fetal gender and pre-eclampsia (Poster presentation)', Journal of the Society for Gynecologic Investigation (Vol. 13, no. 2: 667) Scientific Program and Abstracts 53rd Annual Meeting (2006) [E3]
Co-authors Ian Wright
2006 Scott NM, Wyper HJ, Osei-Kumah A, Smith R, Murphy VE, Clifton VL, 'Sex specific differences in placental cytokine expression and their relationship to fetal glucocorticoid exposure', Journal of the Society for Gynecologic Investigation. Scientific Program and Abstracts 53rd Annual Meeting (2006) [E3]
Co-authors Roger Smith, Vanessa Murphy
2005 Murphy VE, Clifton VL, Talbot PI, Gibson PG, 'Severe asthma exacerbations during pregnancy', Perinatal Society of Australia and New Zealand 9th Annual Congress, Adelaide, 13-16 March, 2005 (2005) [E3]
Citations Scopus - 125Web of Science - 111
Co-authors Vanessa Murphy, Peter Gibson
2005 Murphy VE, Clifton VL, Gibson PG, 'Asthma exacerbations during pregnancy are associated with low birth weight', European Respiratory Journal (2005) [C3]
Co-authors Peter Gibson, Vanessa Murphy
2005 Scott NM, Wyper H, Osei-Kumah A, Smith R, Hodgson DM, Clifton VL, 'Sex Differences in Placental Cytokine Expression and their Relationship to Fetal Cortisol', Endocrine Journal:The Endocrine Society of Australia, Proceedings of the 48th Annual Scientific Meeting (2005) [E3]
Co-authors Deborah Hodgson
2005 Wynne OL, Clifton VL, Murphy VE, Hodyl NA, Krivanek K, Smith D, et al., 'The Effects of Prenatal Endotoxin Exposure on Placental 11-HSD2 Activity and the Developing HPA Axis in the Fischer 344 Rat', Australian Neuroscience Society: Proceedings of the 25th Annual (2005) [E3]
Co-authors Vanessa Murphy, Deborah Hodgson, Olivia Wynne, Philip Hansbro
2005 Murphy VE, Talbot PI, Clifton VL, Gibson PG, 'Severe asthma exacerbations during pregnancy', American Journal of Respiratory and Critical Care (2005) [C3]
Co-authors Vanessa Murphy, Peter Gibson
2005 Murphy VE, Clifton VL, Talbot PI, Gibson PG, 'Self-management education for pregnant women with asthma', American Journal of Respiratory and Critical Care Medicine (2005) [C3]
Co-authors Vanessa Murphy, Peter Gibson
2005 Gibson PG, Giles WB, Zakar T, Smith R, Kessell CG, Clifton VL, Murphy VE, 'Inflammatory factors have sex-specified effects on fetal growth in humans', Ceska Gynekologie (2005) [C3]
Co-authors Roger Smith, Peter Gibson, Vanessa Murphy
2005 Murphy VE, Talbot PI, Clifton VL, Gibson PG, 'Severe asthma exacerbations during pregnancy', Respirology (2005) [C3]
DOI 10.1097/01.AOG.0000185281.21716.02
Co-authors Peter Gibson, Vanessa Murphy
2005 Murphy VE, Clifton VL, Talbot PI, Gibson PG, 'Self-management education for pregnant women with asthma. Thoracic Society of Australia and New Zealand Annual Scientific Meeting, Perth, 18-23 March, 2005', Respirology (2005) [C3]
Co-authors Peter Gibson, Vanessa Murphy
2005 Fittock R, Murphy VE, Smith R, Zarzycki PK, Clifton VL, 'Metabolism of synthetic glucocorticoids used for the treatment of asthma by placental 11beta-hydoxysteroid dehydrogenase 2', Endocrine Society of Australia Annual Scientific Meeting, Adelaide, 22-25 Sept, 2002 (2005) [E3]
Co-authors Vanessa Murphy, Roger Smith
2004 Gibson PG, Murphy VE, Kessell CG, Talbot PI, Giles WB, Smith R, Clifton VL, 'Effect of fetal gender on maternal athsma during pregnancy', American Journal of Respiratory Care (2004) [C3]
Co-authors Vanessa Murphy, Roger Smith, Peter Gibson
2004 Talbot PI, Murphy VE, Kessell CG, Giles WB, Smith R, Gibson PG, Clifton VL, 'Effect of fetal gender on maternal asthma during pregnancy', Respirology (2004) [C3]
Co-authors Vanessa Murphy, Roger Smith, Peter Gibson
2004 Clifton VL, Murphy VE, Giles WB, 'Gender specific mechanisms of human fetal cortisol metabolism and immunity', Reproductive Sciences (2004) [C3]
Co-authors Vanessa Murphy
2004 Murphy VE, Kessell CG, Talbot PI, Gibson PG, Clifton VL, 'Asthma education, lung function and inflammation in pregnant women: relation to birth weight', 8th Annual Conference of the Perinatal Society of Australia and New Zealand, Sydney, 15-19 March, 2004 (2004) [E3]
Co-authors Peter Gibson, Vanessa Murphy
2004 Clifton VL, Murphy VE, Gibson PG, 'Gender specific growth mechanisms in the human fetus', 8th Annual Conference of the Perinatal Society of Australia and New Zealand, Sydney, 15-19 March, 2004 (2004) [E3]
Co-authors Peter Gibson, Vanessa Murphy
2004 Delahunty M, Fittock R, Murphy VE, Smith R, Zarzycki PK, Clifton VL, 'Metabolism of synthetic glucocortcoids used for the treatment of asthma by the human placenta', Conference of the Perinatal Society of Australia and New Zealand, Sydney, 15-19 March, 2004 (2004) [E3]
Co-authors Roger Smith, Vanessa Murphy
2004 Murphy VE, Gibson PG, Kessell CG, Clifton VL, 'Asthma self-management education for pregnant women delivered in an antenatal clinic setting', Perinatal Scoiety of Australian and New Zealand 9th annual Congress, Adelaide, 13-16 March (2004) [E3]
Co-authors Peter Gibson, Vanessa Murphy
2003 Murphy VE, Gibson PG, Giles WB, Smith R, Clifton VL, 'A novel model for examining fetal growth restriction in human pregnancy', Reproductive Sciences (2003) [C3]
Co-authors Peter Gibson, Roger Smith, Vanessa Murphy
2003 Murphy VE, Johnson RF, Wang Y, Akinsanya K, Gibson PG, Smith R, Clifton VL, 'A proteomic analysis of maternal plasma, umbilical cord plasma and placenta in asthmatic and non-asthmatic pregnancies', Australian Society for Medical Research, National Scientific Conference, Glenelg, 22-24 Nov, 2003 (2003) [E3]
Co-authors Roger Smith, Peter Gibson, Vanessa Murphy
2003 Murphy VE, Gibson PG, Giles WB, Smith R, Clifton VL, 'The effect of fetal gender on maternal inflammation and lung function in asthmatic pregnancies', Endocrine Society of Australia Annual Meeting, Melbourne 14-17 Sept, 2003 (2003) [E3]
Co-authors Vanessa Murphy, Roger Smith, Peter Gibson
2003 Scott NM, Osei-Kumah A, Murphy VE, Clifton VL, 'Are female fetuses more sensitive to the effects of inflammation than male fetuses?', Endocrine Society of Australian Annual Scientific Meeting, Melbourne, 14-17 Sept, 2003 (2003) [E3]
Co-authors Vanessa Murphy
2003 Clifton VL, Fittock R, Murphy VE, Smith R, 'Metabolism of semi-synthetic glucocorticoids by the human placenta', Placenta (2003) [C3]
Co-authors Vanessa Murphy, Roger Smith
2002 Murphy VE, Zakar T, Smith R, Giles WB, Kessell CG, Clifton VL, 'Maternal asthma affects fetal growth in a gender specific manner and is associated with reduced placental 11beta-HSD2 activity and altered sensitivity to cortisol', Reproductive Sciences (2002) [C3]
Co-authors Vanessa Murphy, Roger Smith
2002 Murphy VE, Gibson PG, Giles WB, Zakar T, Smith R, Kessell CG, Clifton VL, 'Sex-specific changes in placental function and fetal growth and development in pregnancies complicated by ashtma', Endocrine Society of Australia Annual Scientific Meeting, Adelaide, 22-25 Sept, 2002 (2002) [E3]
Co-authors Roger Smith, Vanessa Murphy, Peter Gibson
2001 Kessell C, McDonald V, Pratt P, Cookson K, Wild K, Clifton V, Gibson PG, 'Evaluation of an asthma education programme delivered in an antenatal clinic', Respirology (2001)

Severe and poorly controlled asthma may lead to adverse outcomes for mothers and their babies. An asthma management and education programme was established in the Antenatal Clinic... [more]

Severe and poorly controlled asthma may lead to adverse outcomes for mothers and their babies. An asthma management and education programme was established in the Antenatal Clinic (ANC) of John Hunter Hospital to optimise asthma management in pregnant women with asthma. Aim: The aim of this study was to evaluate the effect of the Asthma Management Service in the John Hunter Hospital ANC. Design: Longitudinal analytic survey. Method: Women were enrolled in their first trimester and underwent an initial assessment of asthma severity, treatment and management skills. Deficits were corrected by skills education, medical assessment and treatment. Records were reviewed of pregnant women with asthma who attended the Asthma Management Service between January 1998 and December 1999. Results: 83 women were enrolled and 72 patients attended between 2 and 8 visits during pregnancy, depending upon asthma severity. Conclusion: After structured asthma education, there were significant improvements in asthma knowledge and management skills. The antenatal clinic is a opportune setting for asthma education among pregnant women with asthma. Asthma Control Visit 1 After Education p Value Night Symptoms 53% 42% 0.15 Morning Symptoms 66% 46% 0.01 Activity Limitation 35% 30% 0.65 Asthma Skills pMDI: Inadequate 13% 0% 0.001 Spacer: Inadequate 2% 0% 0.50 Medication Knowledge 47% 88% 0.0001 Action Plan 13% 78% 0.0001 Peak Flow Monitoring 8% 78% 0.0001.

Co-authors Peter Gibson, Vanessa Mcdonald
2001 Murphy VE, Zakar T, Gibson PG, Giles WB, Smith R, Clifton VL, 'Pleacental 11beta-HSD2 activity in asthmatic women', Reproductive sciences (2001) [C3]
Co-authors Roger Smith, Vanessa Murphy, Peter Gibson
2001 Murphy VE, Zakar T, Smith R, Giles WB, Gibson PG, Clifton VL, 'A potential mechnism for growth retardation in pregnancies complicated by asthma', Endocrine Society of Australia Annual Scientific Meeting, Gold Coast, 9-12 Sept, 2001 (2001) [E3]
Co-authors Peter Gibson, Roger Smith, Vanessa Murphy
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Grants and Funding

Summary

Number of grants 53
Total funding $4,637,152

Click on a grant title below to expand the full details for that specific grant.


20092 grants / $170,000

The Ontogeny of Pain Behaviour: A Novel Neuroimmune Pathway.$150,000

Funding body: ARC (Australian Research Council)

Funding body ARC (Australian Research Council)
Project Team Professor Deborah Hodgson, Conjoint Associate Professor Vicki Clifton, Professor Kenneth Beagley, Professor Yehuda Shavit
Scheme Discovery Projects
Role Investigator
Funding Start 2009
Funding Finish 2011
GNo G0188757
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

The role of early life infection in the predisposition to anxiety in adulthood$20,000

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Professor Deborah Hodgson, Conjoint Associate Professor Mick Hunter, Conjoint Associate Professor Vicki Clifton, Assoc. Prof Marie Dziaddek, Dr Jonathan Hirst
Scheme Near Miss Grant
Role Investigator
Funding Start 2009
Funding Finish 2009
GNo G0189814
Type Of Funding Internal
Category INTE
UON Y

20082 grants / $575,836

Research Fellowship$537,500

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Conjoint Associate Professor Vicki Clifton
Scheme Research Fellowships
Role Lead
Funding Start 2008
Funding Finish 2012
GNo G0187340
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

Characterisation of Cardiovascular Adaptation in Newborn Infants$38,336

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Conjoint Professor Ian Wright, Conjoint Associate Professor Vicki Clifton
Scheme Project Grant
Role Investigator
Funding Start 2008
Funding Finish 2008
GNo G0189360
Type Of Funding Contract - Aust Non Government
Category 3AFC
UON Y

20078 grants / $1,549,796

Managing asthma in pregnancy: the MAP study$805,875

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Conjoint Professor Peter Gibson, Conjoint Associate Professor Vicki Clifton, Emeritus Professor Michael Hensley, Conjoint Professor Warwick Giles
Scheme Project Grant
Role Investigator
Funding Start 2007
Funding Finish 2010
GNo G0186407
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

HMRI 07-33 Maternal asthma and the growth and survival of infants$590,751

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Conjoint Associate Professor Vicki Clifton
Scheme Federal Department of Health and Ageing
Role Lead
Funding Start 2007
Funding Finish 2009
GNo G0187952
Type Of Funding Grant - Aust Non Government
Category 3AFG
UON Y

Role of p38 MAPK in regulating sex specific placental glucocorticoid receptor function in pregnancies complicated by asthma$50,000

Funding body: Asthma Foundation of New South Wales

Funding body Asthma Foundation of New South Wales
Project Team Conjoint Associate Professor Vicki Clifton, Conjoint Professor Peter Gibson, Conjoint Professor Warwick Giles
Scheme Research Grant
Role Lead
Funding Start 2007
Funding Finish 2007
GNo G0187258
Type Of Funding Donation - Aust Non Government
Category 3AFD
UON Y

Nitric Oxide Monitoring System (NIOX)$45,000

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Conjoint Professor Peter Gibson, Conjoint Associate Professor Vicki Clifton, Conjoint Professor Warwick Giles, Emeritus Professor Michael Hensley, Doctor Vanessa Murphy, Conjoint Professor Peter Wark, Professor Vanessa McDonald, Professor Jodie Simpson, Conjoint Associate Professor Bruce Whitehead, Laureate Professor Paul Foster, Professor Phil Hansbro, Professor Lisa Wood
Scheme Equipment Grant
Role Investigator
Funding Start 2007
Funding Finish 2007
GNo G0188193
Type Of Funding Other Public Sector - Commonwealth
Category 2OPC
UON Y

Beta Radiation Counter Instrument facility$25,670

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Laureate Professor Roger Smith, Conjoint Associate Professor Vicki Clifton, Conjoint Professor Tamas Zakar, Conjoint Associate Professor Rick Nicholson, Dr Mark Read, Doctor Cheng Chan, Doctor John Fitter, Conjoint Associate Professor Andrew Bisits, Professor Jon Hirst, Doctor Hannah Palliser, Professor Ian Symonds
Scheme Equipment Grant
Role Investigator
Funding Start 2007
Funding Finish 2007
GNo G0188194
Type Of Funding Other Public Sector - Commonwealth
Category 2OPC
UON Y

Hewlett Packard 7890 series gas chromatograph with accessories$20,000

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Professor Lisa Wood, Conjoint Professor Peter Wark, Conjoint Professor Peter Gibson, Professor Jodie Simpson, Doctor Vanessa Murphy, Laureate Professor Paul Foster, Professor Phil Hansbro, Conjoint Associate Professor Vicki Clifton, Professor Clare Collins, Conjoint Professor Wayne Smith, Professor John Attia
Scheme Equipment Grant
Role Investigator
Funding Start 2007
Funding Finish 2007
GNo G0188191
Type Of Funding Other Public Sector - Commonwealth
Category 2OPC
UON Y

Artist-in-Residence Project$10,000

Funding body: John Boulton

Funding body John Boulton
Project Team Conjoint Associate Professor Vicki Clifton
Scheme Rachel Burgess Project
Role Lead
Funding Start 2007
Funding Finish 2007
GNo G0187812
Type Of Funding Not Known
Category UNKN
UON Y

International Federation of Placetal Associations, Kingston Conference Centre, Ontario, Canada, 17/8/2007 - 23/8/2007$2,500

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Conjoint Associate Professor Vicki Clifton
Scheme Travel Grant
Role Lead
Funding Start 2007
Funding Finish 2007
GNo G0188160
Type Of Funding Internal
Category INTE
UON Y

20068 grants / $724,219

PRC - Priority Research Centre for Reproductive Science$544,282

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Laureate Professor John Aitken, Laureate Professor Roger Smith, Professor Eileen McLaughlin, Professor Brett Nixon, Doctor Shaun Roman, Conjoint Associate Professor Vicki Clifton, Conjoint Professor Warwick Giles, Professor Jon Hirst, Conjoint Associate Professor Rick Nicholson, Professor Ian Symonds
Scheme Priority Research Centre
Role Investigator
Funding Start 2006
Funding Finish 2013
GNo G0186945
Type Of Funding Internal
Category INTE
UON Y

The relationship between eosinophilic inflammation, viral infection and severe asthma exacerbations during pregnancy$50,000

Funding body: Asthma Foundation of New South Wales

Funding body Asthma Foundation of New South Wales
Project Team Doctor Vanessa Murphy, Conjoint Associate Professor Vicki Clifton, Emeritus Professor Michael Hensley, Conjoint Professor Warwick Giles, Conjoint Professor Peter Gibson
Scheme Research Grant
Role Investigator
Funding Start 2006
Funding Finish 2006
GNo G0186029
Type Of Funding Donation - Aust Non Government
Category 3AFD
UON Y

The effect of maternal asthma and its treatment on placental and fetal glucocorticoid receptor expression$50,000

Funding body: Asthma Foundation of New South Wales

Funding body Asthma Foundation of New South Wales
Project Team Conjoint Associate Professor Vicki Clifton, Conjoint Professor Peter Gibson, Laureate Professor Roger Smith, Conjoint Professor Warwick Giles, Mrs Pip Talbot
Scheme Research Grant
Role Lead
Funding Start 2006
Funding Finish 2006
GNo G0186137
Type Of Funding Donation - Aust Non Government
Category 3AFD
UON Y

Viral infections and asthma exacerbations during pregnancy: characteristics, mechanisms and consequences$19,100

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Doctor Vanessa Murphy, Conjoint Associate Professor Vicki Clifton, Emeritus Professor Michael Hensley, Conjoint Professor Warwick Giles
Scheme Near Miss Grant
Role Investigator
Funding Start 2006
Funding Finish 2006
GNo G0186061
Type Of Funding Internal
Category INTE
UON Y

Effect of Maternal Asthma during Pregnancy on the Fetal Immune System$18,837

Funding body: Asthma Foundation of New South Wales

Funding body Asthma Foundation of New South Wales
Project Team Conjoint Associate Professor Vicki Clifton, Laureate Professor Roger Smith, Ms Naomi Scott
Scheme PhD Scholarships
Role Lead
Funding Start 2006
Funding Finish 2006
GNo G0185987
Type Of Funding Donation - Aust Non Government
Category 3AFD
UON Y

Neurosteroids in the neonatal brain: potential role in protecting against perinatal brain injury$16,000

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Professor Jon Hirst, Conjoint Associate Professor Vicki Clifton
Scheme Project Grant
Role Investigator
Funding Start 2006
Funding Finish 2006
GNo G0186100
Type Of Funding Contract - Aust Non Government
Category 3AFC
UON Y

Perinatal programming of human anxiety disorders$16,000

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Professor Deborah Hodgson, Conjoint Associate Professor Vicki Clifton
Scheme Project Grant
Role Investigator
Funding Start 2006
Funding Finish 2006
GNo G0186104
Type Of Funding Contract - Aust Non Government
Category 3AFC
UON Y

Maternal asthma during pregnancy alters placental and fetal response to glucocorticoid in a sexually dimorphic manner$10,000

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Conjoint Associate Professor Vicki Clifton
Scheme Near Miss Grant
Role Lead
Funding Start 2006
Funding Finish 2006
GNo G0186132
Type Of Funding Internal
Category INTE
UON Y

20054 grants / $32,805

Effect of maternal asthma during pregnancy on the fetal immune system$18,837

Funding body: Asthma Foundation of New South Wales

Funding body Asthma Foundation of New South Wales
Project Team Conjoint Associate Professor Vicki Clifton, Ms Naomi Scott
Scheme PhD Scholarships
Role Lead
Funding Start 2005
Funding Finish 2005
GNo G0184944
Type Of Funding Donation - Aust Non Government
Category 3AFD
UON Y

Perinatal programming of the neuroendocrine and immune system: Implications for long term health outcomes$6,029

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Professor Deborah Hodgson, Conjoint Associate Professor Vicki Clifton
Scheme Project Grant
Role Investigator
Funding Start 2005
Funding Finish 2005
GNo G0184734
Type Of Funding Internal
Category INTE
UON Y

The effect of maternal infection on predisposition towards asthma in adulthood$6,029

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Professor Deborah Hodgson, Conjoint Associate Professor Vicki Clifton, Professor Phil Hansbro
Scheme Project Grant
Role Investigator
Funding Start 2005
Funding Finish 2005
GNo G0184735
Type Of Funding Internal
Category INTE
UON Y

DoHAD - 3rd International Congress on $1,910

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Conjoint Associate Professor Vicki Clifton
Scheme Travel Grant
Role Lead
Funding Start 2005
Funding Finish 2005
GNo G0185775
Type Of Funding Internal
Category INTE
UON Y

20044 grants / $441,900

The effect of asthma during pregnancy on placental function and fetal development$417,500

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Conjoint Associate Professor Vicki Clifton
Scheme Career Development Fellowships
Role Lead
Funding Start 2004
Funding Finish 2008
GNo G0183761
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

Perinatal neuroendocrine programming of adult immunocompetence$12,000

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Professor Deborah Hodgson, Conjoint Associate Professor Vicki Clifton
Scheme Project Grant
Role Investigator
Funding Start 2004
Funding Finish 2004
GNo G0183353
Type Of Funding Internal
Category INTE
UON Y

The effect of maternal inflammation on fetal development, placental function and neonatal immune competence: An animal model of asthma during pregnancy$10,000

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Professor Deborah Hodgson, Conjoint Associate Professor Vicki Clifton, Professor Phil Hansbro
Scheme Project Grant
Role Investigator
Funding Start 2004
Funding Finish 2004
GNo G0183352
Type Of Funding Internal
Category INTE
UON Y

Society of Gynecologic Investigation, 24-28 March 2004, USA$2,400

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Conjoint Associate Professor Vicki Clifton
Scheme Travel Grant
Role Lead
Funding Start 2004
Funding Finish 2004
GNo G0183882
Type Of Funding Internal
Category INTE
UON Y

20035 grants / $427,550

The effect of asthma during pregnancy on placental function and fetal development$360,000

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Conjoint Associate Professor Vicki Clifton
Scheme Project Grant
Role Lead
Funding Start 2003
Funding Finish 2005
GNo G0181764
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

Sievers NOA 280i Nitric Oxide Analyser$36,650

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Conjoint Professor Peter Gibson, Conjoint Associate Professor Vicki Clifton, Conjoint Associate Professor Michael Boyle, Laureate Professor Rodney Scott
Scheme Equipment Grant
Role Investigator
Funding Start 2003
Funding Finish 2003
GNo G0183059
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

Use of SELDI-TOF-MS to identify proteins relevant to human labour$17,000

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Laureate Professor Roger Smith, Conjoint Associate Professor Vicki Clifton, Conjoint Professor Tamas Zakar, Conjoint Associate Professor Andrew Bisits
Scheme Special Project Grant
Role Investigator
Funding Start 2003
Funding Finish 2003
GNo G0183114
Type Of Funding Internal
Category INTE
UON Y

The effect of prenatal exposure to bacteria on placental 11?-HSD activity in the guinea pig: a potential mechanism for altered stress sensitivity in adulthood$11,500

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Professor Deborah Hodgson, Conjoint Associate Professor Vicki Clifton
Scheme Project Grant
Role Investigator
Funding Start 2003
Funding Finish 2003
GNo G0182318
Type Of Funding Internal
Category INTE
UON Y

Society of Gynecologic Investigation, Washinton DC, USA 25 - 30 March, 2003$2,400

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Conjoint Associate Professor Vicki Clifton
Scheme Travel Grant
Role Lead
Funding Start 2003
Funding Finish 2003
GNo G0182798
Type Of Funding Internal
Category INTE
UON Y

20024 grants / $103,548

Effect of fetal factors on maternal asthma and fetal outcome.$56,842

Funding body: Asthma Foundation of New South Wales

Funding body Asthma Foundation of New South Wales
Project Team Miss Annette Osei-Kumah, Conjoint Associate Professor Vicki Clifton
Scheme PhD Scholarships
Role Investigator
Funding Start 2002
Funding Finish 2004
GNo G0181707
Type Of Funding Donation - Aust Non Government
Category 3AFD
UON Y

The Impact of Asthma During Pregnancy on Placental Function.$40,000

Funding body: Royal Australian and New Zealand College of Obstetricians and Gynaecologists

Funding body Royal Australian and New Zealand College of Obstetricians and Gynaecologists
Project Team Conjoint Associate Professor Vicki Clifton
Scheme Arthur Wilson Memorial Scholarship
Role Lead
Funding Start 2002
Funding Finish 2003
GNo G0180992
Type Of Funding Contract - Aust Non Government
Category 3AFC
UON Y

Effect of pregnancy on maternal asthma, placental function and fetal development.$5,000

Funding body: Asthma Foundation of New South Wales

Funding body Asthma Foundation of New South Wales
Project Team Conjoint Associate Professor Vicki Clifton
Scheme Research Grant
Role Lead
Funding Start 2002
Funding Finish 2002
GNo G0181496
Type Of Funding Donation - Aust Non Government
Category 3AFD
UON Y

International Federation of Placental Associations Annual Conference, Melbourne 6-10 October, 2002$1,706

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Conjoint Associate Professor Vicki Clifton
Scheme Travel Grant
Role Lead
Funding Start 2002
Funding Finish 2002
GNo G0182161
Type Of Funding Internal
Category INTE
UON Y

20014 grants / $36,001

Beckman Coulter HPLC Detector and software. Extech circulation heating bath with accessories and software$19,000

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Laureate Professor Roger Smith, Conjoint Associate Professor Vicki Clifton, Doctor Sam Mesiano, Conjoint Associate Professor Andrew Bisits, Conjoint Professor Warwick Giles
Scheme Equipment Grant
Role Investigator
Funding Start 2001
Funding Finish 2001
GNo G0181174
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

Beckman Coulter HPLC Detector and software. Extech circulation heating bath with accessories and software$10,836

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Laureate Professor Roger Smith, Conjoint Associate Professor Vicki Clifton, Doctor Sam Mesiano, Conjoint Associate Professor Andrew Bisits, Conjoint Professor Warwick Giles
Scheme University/NHMRC Equipment Grant Funds
Role Investigator
Funding Start 2001
Funding Finish 2001
GNo G0181175
Type Of Funding Internal
Category INTE
UON Y

Visit of Dr Qing Gu from 1 August 2001 to 1 November 2001$3,921

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Conjoint Associate Professor Vicki Clifton
Scheme Visitor Grant
Role Lead
Funding Start 2001
Funding Finish 2001
GNo G0180902
Type Of Funding Internal
Category INTE
UON Y

Annual meeting of Society Gynecologic Investigation, Canada 9-19 March 2001$2,244

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Conjoint Associate Professor Vicki Clifton
Scheme Travel Grant
Role Lead
Funding Start 2001
Funding Finish 2001
GNo G0180695
Type Of Funding Internal
Category INTE
UON Y

20003 grants / $270,737

The impact of servere asthma during pregnancy on placental function and fetal hypothalamic-pituitary-adrenal function.$205,737

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Conjoint Associate Professor Vicki Clifton
Scheme Project Grant
Role Lead
Funding Start 2000
Funding Finish 2002
GNo G0178498
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

Effect of severe asthma during pegnancy on placental function and the fetal hypothalamic pituitary adrenal axis.$45,000

Funding body: Asthma Foundation of New South Wales

Funding body Asthma Foundation of New South Wales
Project Team Conjoint Associate Professor Vicki Clifton
Scheme Research Grant
Role Lead
Funding Start 2000
Funding Finish 2000
GNo G0179210
Type Of Funding Donation - Aust Non Government
Category 3AFD
UON Y

Glucocorticoid regulation of prostaglandin pathways involved in pre-term labour.$20,000

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Conjoint Professor Tamas Zakar, Conjoint Associate Professor Vicki Clifton
Scheme Research Grant
Role Investigator
Funding Start 2000
Funding Finish 2000
GNo G0180170
Type Of Funding Contract - Aust Non Government
Category 3AFC
UON Y

19994 grants / $67,260

Effect of Severe Asthma During Pregnancy on Placental Function and Fetal Outcome$50,000

Funding body: Asthma Foundation of New South Wales

Funding body Asthma Foundation of New South Wales
Project Team Conjoint Associate Professor Vicki Clifton
Scheme Research Grant
Role Lead
Funding Start 1999
Funding Finish 1999
GNo G0178279
Type Of Funding Donation - Aust Non Government
Category 3AFD
UON Y

Corticotropin-releasing hormone effects on connexin expression and gap junction formation in human myometrium$10,193

Funding body: Ramaciotti Foundations

Funding body Ramaciotti Foundations
Project Team Conjoint Associate Professor Vicki Clifton, Laureate Professor Roger Smith
Scheme Research Grant
Role Lead
Funding Start 1999
Funding Finish 1999
GNo G0177963
Type Of Funding Aust Competitive - Non Commonwealth
Category 1NS
UON Y

Young Medical Researcher of the Year.$5,000

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Conjoint Associate Professor Vicki Clifton
Scheme Research Grant
Role Lead
Funding Start 1999
Funding Finish 1999
GNo G0179044
Type Of Funding Contract - Aust Non Government
Category 3AFC
UON Y

Society of Gynecological Investigation Atlanta, Georgia, USA.$2,067

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Conjoint Associate Professor Vicki Clifton
Scheme Travel Grant
Role Lead
Funding Start 1999
Funding Finish 1999
GNo G0179064
Type Of Funding Internal
Category INTE
UON Y

19985 grants / $237,500

The Effect of Severe Asthma During Pregnancy on Placental Function and Fetal Outcome$130,000

Funding body: Gladys M Brawn Memorial Fellowships

Funding body Gladys M Brawn Memorial Fellowships
Project Team Conjoint Associate Professor Vicki Clifton
Scheme Postdoctoral Research Fellowship
Role Lead
Funding Start 1998
Funding Finish 1999
GNo G0178251
Type Of Funding Donation - Aust Non Government
Category 3AFD
UON Y

Effect of severe asthma during pregnancy on placental function and fetal outcome$90,000

Funding body: Asthma Foundation of New South Wales

Funding body Asthma Foundation of New South Wales
Project Team Conjoint Associate Professor Vicki Clifton, Conjoint Professor Peter Gibson, Laureate Professor Roger Smith
Scheme Research Grant
Role Lead
Funding Start 1998
Funding Finish 1999
GNo G0177659
Type Of Funding Donation - Aust Non Government
Category 3AFD
UON Y

Effect of severe asthma during pregnancy on placental function and fetal outcome.$11,500

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Conjoint Associate Professor Vicki Clifton, Conjoint Professor Peter Gibson
Scheme Project Grant
Role Lead
Funding Start 1998
Funding Finish 1998
GNo G0177211
Type Of Funding Internal
Category INTE
UON Y

Travel to Dept of Physiology, Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada$5,000

Funding body: Ramaciotti Foundations

Funding body Ramaciotti Foundations
Project Team Conjoint Associate Professor Vicki Clifton
Scheme Research Grant
Role Lead
Funding Start 1998
Funding Finish 1998
GNo G0177719
Type Of Funding Aust Competitive - Non Commonwealth
Category 1NS
UON Y

Effect of CRH and oxytocin on connexin formation in the human myometrium in vitro$1,000

Funding body: Ian Potter Foundation

Funding body Ian Potter Foundation
Project Team Conjoint Associate Professor Vicki Clifton
Scheme Travel Grant
Role Lead
Funding Start 1998
Funding Finish 1998
GNo G0177885
Type Of Funding Donation - Aust Non Government
Category 3AFD
UON Y
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Research Supervision

Number of supervisions

Completed15
Current2

Total current UON EFTSL

PhD0.3

Current Supervision

Commenced Level of Study Research Title Program Supervisor Type
2007 PhD Characteristics of Sex-specific Differences in Cardiovascular Adaptation in the First 2 Years of Life PhD (Paediatrics), Faculty of Health and Medicine, The University of Newcastle Co-Supervisor
2006 Masters Analysis of stillbirths from the john HUnter hospital Obstetric Database 1995-199 Epidemiology, University of Newcastle Principal Supervisor

Past Supervision

Year Level of Study Research Title Program Supervisor Type
2012 PhD Effect of Maternal Asthma During Pregnancy on Aspects of Placental Immune Function PhD (Reproductive Medicine), Faculty of Health and Medicine, The University of Newcastle Principal Supervisor
2011 PhD Impact of Neonatal Infection on Adult Hippocampal Glucocorticoid and Mineralocorticoid Receptors and Hypothalamic-Pituitary-Adrenal Axis Outcomes PhD (Psychology - Science), Faculty of Science, The University of Newcastle Co-Supervisor
2011 PhD Human Endogenous Retroviruses and Immune Tolerance in Pregnancy PhD (Medicine), Faculty of Health and Medicine, The University of Newcastle Co-Supervisor
2010 PhD Syncytin and Placental Exosomes: New Insights in Immunology of Pregnancy PhD (Reproductive Medicine), Faculty of Health and Medicine, The University of Newcastle Co-Supervisor
2009 PhD Effect of Maternal Asthma During Pregnancy on Circulating Cytokines, Immune Cell Profile and Airway Inflammatory Mediator Release In-Vitro PhD (Medicine), Faculty of Health and Medicine, The University of Newcastle Principal Supervisor
2008 PhD The Influence of Sex-Specific Differences in Feto-Placental Glucocorticoid Metabolism on the Preterm Microvasculature and Transitional Circulation PhD (Medicine), Faculty of Health and Medicine, The University of Newcastle Principal Supervisor
2005 Honours Glucocorticoid receptor expression in placentae of pregnancies complicated by asthma. Biol Sc Not Elsewhere Classifd, University of Newcastle Principal Supervisor
2004 PhD The Effect of Maternal Asthma During Pregnancy on Placental Function and Fetal Development PhD (Medicine), Faculty of Health and Medicine, The University of Newcastle Principal Supervisor
2004 Honours Effect of inhaled glucocorticoids on 11 beta HSD2 activity in placentae of pregnancies complicated by asthma Biol Sc Not Elsewhere Classifd, University of Newcastle Principal Supervisor
2003 Honours Effect of CRH on microvascular function during pregnancy Biol Sc Not Elsewhere Classifd, University of Newcastle Co-Supervisor
2003 Honours Why are females more sensitive than males to inflammatory stimuli Biol Sc Not Elsewhere Classifd, University of Newcastle Principal Supervisor
2002 Honours Placental metabolism of semi-synthetic glucocorticoids Biol Sc Not Elsewhere Classifd, University of Newcastle Co-Supervisor
2001 Honours Prostaglandin production in human placenta and membranes Biol Sc Not Elsewhere Classifd, University of Newcastle Co-Supervisor
2001 Honours Effect of CRH on microvascular function in human skin Biochemistry & Cell Biology, University of Newcastle Principal Supervisor
2000 Honours Effect of inflammatory cytokines on myometrial connexins Biol Sc Not Elsewhere Classifd, University of Newcastle Principal Supervisor
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Conjoint Associate Professor Vicki Clifton

Position

Conjoint Associate Professor
School of Medicine and Public Health
Faculty of Health and Medicine

Contact Details

Email vicki.clifton@newcastle.edu.au
Phone (02) 4985 5641
Fax (02) 4921 4394

Office

Room JHH
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